Individual
TERRI MCCORMACK CAICEDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
127 E ROSE ST STE F, WALLA WALLA, WA 99362-5009
(509) 301-2520
Mailing address
127 E ROSE ST STE F, WALLA WALLA, WA 99362-5009
(509) 301-2520
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60790840
WA
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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