| NPI | 1255046231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA M IBARRA Owner/Provider 253-240-1964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2023-01-13 |
| Last Update Date | 2023-01-13 |