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Individual
MARY ELAINE PENTON
Active
Individual
MARY ELAINE PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP, LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP 00002890
WA
101YM0800X
Mental Health Counselor
LH 60158767
WA
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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