| NPI | 1104569623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MCCLINCEY Co Owner 360-255-8260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-04-14 |
| Last Update Date | 2022-04-14 |