| NPI | 1841651585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY WILLIAMS Office Manager 360-363-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA MC60590118) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 104100000X Social Worker | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2023-07-20 |