Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 1041C0700X | Clinical Social Worker | LW00009583 | WA |
NPI | 1003064817 |
---|---|
Provider Name | Katharine Margaret Botelle Wolhart |
First Address | Stanwood, WA 98292-5437 |
Second Address | Bellingham, WA 98226-9822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 11/03/2021 |