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107 N Tower Ave Centralia WA 98531-4253 | |
| (360) 330-2832 | |
| (360) 330-0284 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 107 N Tower Ave, Centralia, Washington |
| Authorized Official Name and Position | Darlene R Tewault (THERAPIST) |
| Authorized Official Contact | 3603302832 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
107 N Tower Ave Centralia WA 98531-4253 Ph: (360) 330-2832 | 107 N Tower Ave Centralia WA 98531-4253 Ph: (360) 330-2832 |
| NPI Number | 1942439732 |
|---|---|
| Provider Enumeration Date | 07/14/2009 |
| Last Update Date | 07/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942439732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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