Organization
BLUE RIVER COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY ANN MAYHALL PHD (CEO/THERAPIST)
(425) 429-1588
Entity
Organization
Contact information
Practice address
22728 228TH AVENUE SE, MAPLE VALLEY, WA 98038
(425) 429-1588
Mailing address
26207 MAPLE VALLEY BLACK DIAMOND HWY, SUITE D, MAPLE VALLEY, WA 98038
(425) 429-1588
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60449477
WA
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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