Individual
MIRACLE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2624 N DIVISION ST # 1091, SPOKANE, WA 99207-2129
(509) 542-7763
Mailing address
2624 N DIVISION ST # 1091, SPOKANE, WA 99207-2129
(509) 542-7763
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC61408248
WA
Other
Enumeration date
03/01/2023
Last updated
04/15/2024
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