Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MC60907139 | WA |
Y | 101YM0800X | Mental Health Counselor | LH61174719 | WA |
N | 225400000X | Rehabilitation Practitioner |
NPI | 1043629306 |
---|---|
Provider Name | Sarah Willick |
First Address | Port Townsend, WA 98368-2273 |
Second Address | Port Townsend, WA 98368-2273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2014 |
Last Update Date | 09/06/2021 |