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Individual

MARYLYNN ANTUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
14 E CASINO RD, BUILDING D, EVERETT, WA 98208-2628
(425) 374-4279
Mailing address
1622 N 202ND PL, SHORELINE, WA 98133-3335

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00005698
WA

Other

Enumeration date
02/10/2012
Last updated
02/10/2012
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