Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | CG60166783 | WA |
Y | 101YM0800X | Mental Health Counselor | CG60166783 | WA |
NPI | 1003252545 |
---|---|
Provider Name | Ms. Brenda Lynne' Miller-Sermeno |
First Address | Seattle, WA 98122-2735 |
Second Address | Seattle, WA 98122-2735 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2013 |
Last Update Date | 10/05/2013 |