Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH60227238 | WA |
NPI | 1003096702 |
---|---|
Provider Name | Kimberly Lynn Arbuckle |
First Address | Tacoma, WA 98403-3133 |
Second Address | Tacoma, WA 98403-3133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2007 |
Last Update Date | 28/01/2015 |