| NPI | 1417356759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY SCAMPOLI Owner 360-386-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60435605) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |