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Individual
MR. IAN T KAVANAUGH
Active
Individual
MR. IAN T KAVANAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., LMHC, CN
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60331316
WA
133N00000X
Nutritionist
NU60187446
WA
Other
Enumeration date
06/05/2008
Last updated
04/05/2017
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