| NPI | 1750597803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL J HATHAWAY Owner 360-452-1775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA AP30006082) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-02-08 |