Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | LH00003564 | WA |
N | 102L00000X | Psychologist | LH00003564 | WA |
N | 103T00000X | Psychologist | LH00003564 | WA |
NPI | 1003970047 |
---|---|
Provider Name | Mrs. Diana N.a. Mandell |
First Address | Bellevue, WA 98004-7501 |
Second Address | Bellevue, WA 98004-7501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |