| NPI | 1083509277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY EUGENE WALLACE Owner 509-822-8662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-13 |