Individual
CHARLENE DIANE TAKEUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LMFT
Contact information
Practice address
16619 LARCH WAY APT M101, LYNNWOOD, WA 98037-9362
(425) 876-2773
Mailing address
16619 LARCH WAY APT M101, LYNNWOOD, WA 98037-9362
(425) 876-2773
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60329296
WA
106H00000X
Marriage & Family Therapist
LF60522277
WA
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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