Individual
STEPHANIE WIDHALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1321 W BROADWAY AVE, SPOKANE, WA 99201-2053
(509) 473-4810
(509) 473-4840
Mailing address
1321 W BROADWAY AVE, SPOKANE, WA 99201-2053
(509) 473-4810
(509) 473-4840
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60331678
WA
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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