| NPI | 1730538422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JANE POULSON Owner/Manager 509-430-8626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH00005937) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2022-07-15 |