| NPI | 1215258298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CALLIES Owner 360-236-0206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WA PY0003082) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: WA PY0003082) |
| 103TC0700X Psychologist, Clinical (Licence: WA PY0003082) | |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2010-06-14 |