Doctor Name: | MARY ROBERTS |
NPI Number: | 1417373960 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.H.C. |
License Number: | LH 60537867 |
Business Practice Address: | 1659 Layton Rd Freeland, WA - 98249 |
Business Phone Number: | 3603388286 |
Business Fax Number: | |
Mailing Address: | Po Box 333, FREELAND |
State: | WA |
Postal Code: | 982490333 |
Phone Number: | 3603388286 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2014 |
NPI Last Update Date: | 05/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH 60537867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |