| NPI | 1508342759 |
|---|---|
| Doing Business As | LYDIA PLACE |
| Entity Type | Organization |
| Authorized Contact | ERIN SMITH Clinical Director 360-671-7663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2020-03-24 |