| NPI | 1629518394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE DEMARCO Therapist 360-349-6446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA LH 60604130) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA MC60437247) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2018-03-17 |