Individual
MS. BRANDI SUE DEFAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHA, MA, LMFT
Contact information
Practice address
310 3RD AVE NE STE 118, ISSAQUAH, WA 98027-3348
(425) 894-9676
Mailing address
12036 198TH AVE SE, ISSAQUAH, WA 98027-8522
(425) 226-0609
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF60595316
WA
Other
Enumeration date
07/26/2015
Last updated
08/28/2015
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