Individual
JESSICA MAPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5125 N MARKET ST, SPOKANE, WA 99217-6131
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61326028
WA
106S00000X
Behavior Technician
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/09/2019
Last updated
09/07/2022
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