Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH00005184 | WA |
NPI | 1003201203 |
---|---|
Provider Name | Cynthia Benge |
First Address | Seattle, WA 98103-8626 |
Second Address | Seattle, WA 98103-8626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2015 |
Last Update Date | 03/04/2015 |