Organization
SECOND FRUIT WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY AISHA EDWARDS LMHC (OWNER)
(503) 893-5931
Entity
Organization
Contact information
Practice address
2800 E EVERGREEN BLVD STE B, VANCOUVER, WA 98661-4934
(503) 893-5931
Mailing address
2800 E EVERGREEN BLVD STE B, VANCOUVER, WA 98661-4934
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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