| NPI | 1831564764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE ROBERT FERGUSON Therapist 509-438-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: WA LW 60533326) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2015-12-03 |