Healthcare Provider Details

I. General information

NPI: 1467522425
Provider Name (Legal Business Name): DEBRA L GUHLKE M ED, LMHC, DMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 E HAWTHORNE AVE
COLVILLE WA
99114-2629
US

IV. Provider business mailing address

41398 BLUESTERN RD
DAVENPORT WA
99122
US

V. Phone/Fax

Practice location:
  • Phone: 509-684-4597
  • Fax:
Mailing address:
  • Phone: 509-253-4202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00008172
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: