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Individual

RUTH MORGAN WAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICENSED PSYCHOL

Contact information

Practice address
4524 INTELCO LOOP SE, LACEY, WA 98503-5941
(650) 641-2682
Mailing address
PO BOX 7434, TACOMA, WA 98417
(650) 641-2682

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
019051
NY
103TC0700X
Clinical Psychologist
Primary
PY 60474804
WA

Other

Enumeration date
03/20/2012
Last updated
04/11/2018
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