Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CP00003766 | WA |
N | 101YP2500X | Professional Counselor | CL60426086 | WA |
N | 103K00000X | Behavior Analyst | ||
N | 174N00000X | Lactation Consultant |
NPI | 1114368586 |
---|---|
Provider Name | Ms. Nikki Rae Easterling |
First Address | Spokane, WA 99204-2806 |
Second Address | Spokane, WA 99204-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2013 |
Last Update Date | 28/01/2014 |