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1639897051
KELLY C WAYENBERG
GRANDVIEW, WA
NPI
1639897051
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA MHCA.MC.61350395)
Enumeration Date
2022-08-22
Last Update Date
2022-08-22
Business Address
KELLY C WAYENBERG
106 N ELM ST
GRANDVIEW, WA 98930-1009
Phone number: 509-402-9090
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Mailing Address
KELLY C WAYENBERG
106 N ELM ST
GRANDVIEW, WA 98930-1009
Phone number: 509-402-9090
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