# CUP OF COOL WATER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CUP OF COOL WATER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730837899
- **Authorized official:** BLAKE RANDOLPH WALTMAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (509) 747-6686

## Contact information

- **Practice address:** 1106 W 2ND AVE, SPOKANE, WA 99201-4506
- **Practice address phone:** (509) 747-6686
- **Mailing address:** 1106 W 2ND AVE, SPOKANE, WA 99201-4506
- **Mailing address phone:** (509) 747-6686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2022
- **Last updated:** 03/16/2022