Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003357856 |
---|---|
Provider Name | Ms. Lakisha Bearcat Cordelia |
First Address | Everett, WA 98213-0569 |
Second Address | Everett, WA 98203-4543 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2017 |
Last Update Date | 13/03/2017 |