| NPI | 1306130448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY WILSON NICKELL Owner 253-332-0508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC 60164023) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2011-06-07 |