Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH60512430 | WA |
NPI | 1003177718 |
---|---|
Provider Name | Anna Lisa Ochiltre |
First Address | Spokane, WA 99202-1510 |
Second Address | Spokane, WA 99202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2012 |
Last Update Date | 24/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003177718 | (05) | WA |