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 |