Organization
THERESE SOUDANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESE SOUDANT LMFTA (MARRIAGE AND FAMILY THERAPIST)
(206) 618-0688
Entity
Organization
Contact information
Practice address
6869 WOODLAWN AVE NE, SUITE 110, SEATTLE, WA 98115-5469
(206) 618-0688
Mailing address
4415 NE 60TH ST, SEATTLE, WA 98115-7603
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MG60402146
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106H00000X
SOLE PROPRIETORSHIP
WA
Enumeration date
10/03/2016
Last updated
10/03/2016
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