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Organization
THE INFINITE WELL, LLC
Active
Organization
THE INFINITE WELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LENITA JOHNSON (COUNSELOR)
(360) 522-6156
Entity
Organization
Contact information
Practice address
581 MALIBU DR SE, LACEY, WA 98503-1376
(360) 522-6156
Mailing address
5815 LACEY BLVD SE # 8055, LACEY, WA 98503-2459
(360) 522-6156
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC60733448
WA
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
01/12/2018
Last updated
12/06/2021
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