| NPI | 1467855353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMERON CARSON Clinic Manager 360-200-5419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 313) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2015-10-06 |