| NPI | 1548892672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA N ANDERSON Owner 360-500-1704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |