| NPI | 1114344074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE C WINTERS Executive Director 360-348-0205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60412214) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60425258) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60195906) | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |