| NPI | 1205143658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY LEROY FLETCHER Therapist 360-524-5879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LW00004883) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2011-12-23 |