Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | RC00032211 | WA |
NPI | 1003098229 |
---|---|
Provider Name | Heather Lea Marsh |
First Address | Tacoma, WA 98444-3623 |
Second Address | Spanaway, WA 98387-8222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2007 |
Last Update Date | 29/11/2007 |