Individual
AMIE LYNN CONSTABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP, MHP, LMHCA
Contact information
Practice address
6128 CAPITOL BLVD SE, TUMWATER, WA 98501-5271
(360) 704-7170
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61100776
WA
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100840
—
WA
Enumeration date
08/09/2017
Last updated
04/10/2023
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