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1018 Mellen St Centralia WA 98531-1172 | |
| (360) 736-1930 | |
| (360) 736-7782 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1018 Mellen St, Centralia, Washington |
| Authorized Official Name and Position | Renate Jayne Starroff (OWNER) |
| Authorized Official Contact | 3607361930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 569 Centralia WA 98531-0569 Ph: (360) 736-1930 | 1018 Mellen St Centralia WA 98531-1172 Ph: (360) 736-1930 |
| NPI Number | 1194997650 |
|---|---|
| Provider Enumeration Date | 03/25/2008 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194997650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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