| NPI | 1437547007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA NICOLE MANSUROV Owner/Therapist 425-298-6223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA LH 60184919) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA FC 60206027) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |