| |
633 N Mildred St Ste J Tacoma WA 98406-1725 | |
(253) 597-6424 | |
(253) 597-6443 |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 633 N Mildred St Ste J, Tacoma, Washington |
Authorized Official Name and Position | Tasha Church (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2535976424 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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633 N Mildred St Ste J Tacoma WA 98406-1725 Ph: (253) 597-6424 | 633 N Mildred St Ste J Tacoma WA 98406-1725 Ph: (253) 597-6424 |
NPI Number | 1891073813 |
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Provider Enumeration Date | 07/25/2011 |
Last Update Date | 07/25/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891073813 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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