| NPI | 1700379443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK ANTHONY VENBRUX Sole Member 509-336-5972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60249089) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-10-25 |