Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | RC 60062771 | WA |
NPI | 1003055831 |
---|---|
Provider Name | Cynthia Joy Taylor |
First Address | Longview, WA 98632 |
Second Address | Hoquiam, WA 98550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 17/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
RC 60062771 | WASHINGTON STATE DEPARTMENT OF HEALTH (01) | WA |