Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003154709 |
---|---|
Provider Name | Rainy D Thompson |
First Address | Puyallup, WA 98372-3265 |
Second Address | Puyallup, WA 98372-3265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2013 |
Last Update Date | 30/01/2013 |