Individual
LA LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
11752 163RD PL NE, REDMOND, WA 98052-2395
(919) 348-3237
Mailing address
11752 163RD PL NE, REDMOND, WA 98052-2395
(919) 348-3237
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61152108
WA
1041C0700X
Clinical Social Worker
SC60800137
WA
Other
Enumeration date
03/16/2019
Last updated
10/29/2021
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