| NPI | 1578071486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENITA JOHNSON Counselor 360-522-6156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60733448) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2021-12-06 |