Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 60637128 | WA |
NPI | 1003263898 |
---|---|
Provider Name | Lizania Hurtado |
First Address | Wenatchee, WA 98801-3050 |
Second Address | Wenatchee, WA 98801-3050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2016 |
Last Update Date | 21/05/2016 |