Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1831783703 |
---|---|
Provider Name | Daisy Ciclali Noyola |
First Address | Seattle, WA 98144-6103 |
Second Address | Seattle, WA 98118-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |