| NPI | 1144775644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE MITCHELL FAVER Licensed Board Certified Psychologi 360-524-3616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: WA PY60285535) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |