Individual
JOHNNA RAE WACHOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1124 W RIVERSIDE AVE STE LL2, SPOKANE, WA 99201-1132
(509) 994-4518
Mailing address
1124 W RIVERSIDE AVE # LL2, SPOKANE, WA 99201-1132
(509) 994-4518
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC61230425
WA
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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