AMBER FAWN GENTRYSOUTHARD

PUYALLUP, WA
NPI1902079924
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: WA  LW 60072190)
Enumeration Date2008-04-10
Last Update Date2012-04-26
Business Address
AMBER FAWN GENTRYSOUTHARD M.S.W, LICSW
325 E PIONEER
PUYALLUP, WA 98372-3265
Phone number: 253-445-8120
Mailing Address
AMBER FAWN GENTRYSOUTHARD M.S.W, LICSW
325 E PIONEER
PUYALLUP, WA 98372-3265
Phone number: 253-445-8120
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