| NPI | 1215125562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEN DAVID MCCOY Owner 509-338-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WA PY00002727) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2008-03-14 |