| NPI | 1952723538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA V WEATHERBY President/Licensed Psychologist 360-719-2852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WA PY00003931) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00002510) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |