| NPI | 1912766833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY YOUNG Office Manager/Credentialing 360-210-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |