| NPI | 1568834703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA KAY MOUNT Owner / Provider 360-970-8778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH6061175) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: WA MC60449144) |
| 305S00000X Point of Service (Licence: WA CO60332418) | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2016-11-22 |