Individual
OLESYA MIKHEEVA MUSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
435 LARCH ST, ONAWAY, ID 83855-8759
(509) 730-5090
(509) 553-8002
Mailing address
435 LARCH ST, ONAWAY, ID 83855-8759
(509) 730-5090
(509) 553-8002
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MC60974048
WA
103TC0700X
Clinical Psychologist
Primary
PSY203595
ID
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY61045946
WA LICENSE
WA
Enumeration date
08/08/2019
Last updated
05/10/2024
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