Doctor Name: | GERA MCGUIRE |
NPI Number: | 1053741264 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., N.C.C., LMHC |
License Number: | 60422606 |
Business Practice Address: | 1174 Myrtle Ave Enumclaw, WA - 980223563 |
Business Phone Number: | 3604694179 |
Business Fax Number: | |
Mailing Address: | Po Box 44, BLACK DIAMOND |
State: | WA |
Postal Code: | 980100044 |
Phone Number: | 3604694179 |
Fax Number: | |
NPI Enumeration Date: | 11/25/2013 |
NPI Last Update Date: | 05/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 60422606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |