Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MC61188197 | WA |
NPI | 1003221011 |
---|---|
Provider Name | Kevin Sosa |
First Address | Kent, WA 98042-3425 |
Second Address | Bellevue, WA 98005-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2014 |
Last Update Date | 05/11/2021 |