Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LW60302200 | WA |
NPI | 1003215922 |
---|---|
Provider Name | Ms. Teresa Cox |
First Address | Bothell, WA 98011-2345 |
Second Address | Seattle, WA 98108-1532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2014 |
Last Update Date | 15/08/2014 |