| NPI | 1750828430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE E BOLTON Owner 509-789-0489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH 60166791) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |