Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LH00005867 | WA |
NPI | 1003025081 |
---|---|
Provider Name | Linda Rae Richardson |
First Address | Poulsbo, WA 98370-6834 |
Second Address | Silverdale, WA 98383-7720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 08/07/2007 |