| NPI | 1215371414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANDON EUGENE POPPLETON Director/Owner 360-910-1522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY60041144) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2017-11-15 |