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Individual

KODIE JO MOBBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
23801 E APPLEWAY AVE STE 110, LIBERTY LAKE, WA 99019-9687
(509) 386-2888
Mailing address
13799 N MATHESON RD, HAUSER, ID 83854-5599
(509) 386-2888

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
LW61333990
WA
1041C0700X
Clinical Social Worker
SC60903029
WA

Other

Enumeration date
09/28/2017
Last updated
10/17/2022
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