Individual
BREDA KAILYN WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACP, LMHC-A
Contact information
Practice address
1033 SW 152ND ST, BURIEN, WA 98166-1845
(509) 432-1089
Mailing address
1707 S WASHINGTON ST, TACOMA, WA 98405-2070
(509) 432-1089
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC60882904
WA
Other
Enumeration date
12/29/2018
Last updated
12/29/2018
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