Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH60663752 | WA |
NPI | 1003167859 |
---|---|
Provider Name | Shyla Smith |
First Address | Wenatchee, WA 98801-2800 |
Second Address | Wenatchee, WA 98801-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 29/07/2016 |