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1487954145
MISTY RAE SOUTHALL
SPOKANE, WA
NPI
1487954145
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 31849)
Enumeration Date
2010-10-28
Last Update Date
2020-09-11
Business Address
Ms. MISTY RAE SOUTHALL LICSW, MHP, CPC
312 W 8TH AVE
SPOKANE, WA 99204-2506
Phone number: 714-336-6596
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Mailing Address
Ms. MISTY RAE SOUTHALL LICSW, MHP, CPC
312 W 8TH AVE
SPOKANE, WA 99204-2506
Phone number: 509-477-4677
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