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504 N 40th Ave Yakima WA 98908-4311 | |
| (509) 965-8041 | |
| (509) 966-3283 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 504 N 40th Ave, Yakima, Washington |
| Authorized Official Name and Position | Theresa W Hicks (PRESIDENT) |
| Authorized Official Contact | 5094696823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
504 N 40th Ave Yakima WA 98908-4311 Ph: (509) 965-8041 | 504 N 40th Ave Yakima WA 98908-4311 Ph: (509) 965-8041 |
| NPI Number | 1568513422 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568513422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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