Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH60148459 | WA |
NPI | 1003056235 |
---|---|
Provider Name | Mrs. Tina Marie Linares |
First Address | Mount Vernon, WA 98273-0681 |
Second Address | Mount Vernon, WA 98273-3754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2009 |
Last Update Date | 11/11/2010 |