| NPI | 1174036099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE RENEE JORDAN Director 253-365-3964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60806253) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2017-11-14 |