Individual
MS. VIDYA M SUBRAMANIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14524 MAIN ST NE STE 111, DUVALL, WA 98019-8467
(425) 505-1320
Mailing address
PO BOX 1322, DUVALL, WA 98019-1322
(425) 753-1090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-15-19984
—
Other
Enumeration date
07/18/2013
Last updated
06/05/2023
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