Doctor Name: | CAROLE RUTH PICKETT |
NPI Number: | 1316277049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 00022838 |
Business Practice Address: | 16414 92nd St Kpn Lakebay, WA - 983490918 |
Business Phone Number: | 2532224670 |
Business Fax Number: | |
Mailing Address: | Po Box 918, VAUGHN |
State: | WA |
Postal Code: | 983940918 |
Phone Number: | 2532224670 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2009 |
NPI Last Update Date: | 12/31/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 00022838 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |