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Individual
MRS. TONI LODGE
Active
Individual
MRS. TONI LODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CP00002833
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP0002833
WA
101YM0800X
Mental Health Counselor
CP00002833
WA
Other
Enumeration date
07/20/2007
Last updated
07/20/2007
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