Individual
MS. MISTY SMITH PILGRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, MA, LICSW
Contact information
Practice address
46 VILLAGE WAY # 107, PORT LUDLOW, WA 98365-5102
(505) 501-8293
(505) 521-5149
Mailing address
46 VILLAGE WAY # 107, PORT LUDLOW, WA 98365-5102
(505) 501-8293
(505) 521-5149
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW-5066
HI
1041C0700X
Clinical Social Worker
Primary
LW61557825
WA
1041C0700X
Clinical Social Worker
SWB-2022-0189
NM
Other
Enumeration date
09/22/2009
Last updated
07/08/2024
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