Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MC60462200 | WA |
Y | 1041C0700X | Clinical Social Worker | SC 60391911 | WA |
NPI | 1003246760 |
---|---|
Provider Name | Ms. Marie Elizabeth Loeb |
First Address | Seattle, WA 98105-4762 |
Second Address | Seattle, WA 98105-4762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2013 |
Last Update Date | 03/01/2022 |