Doctor Name: | MRS. KERRY ANN MAYHALL |
NPI Number: | 1376795526 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | |
Business Practice Address: | 22728 228th Ave Se Maple Valley, WA - 980388263 |
Business Phone Number: | 4254291588 |
Business Fax Number: | |
Mailing Address: | 26207 Maple Valley Black Diamond Rd Se, Suite D MAPLE VALLEY |
State: | WA |
Postal Code: | 980388378 |
Phone Number: | 4254291588 |
Fax Number: | |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 07/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |