| NPI | 1417088642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW FRANCIS GOODHEART Clinical Director 011476-398-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LW00004955) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |