Healthcare Provider Details

I. General information

NPI: 1083389787
Provider Name (Legal Business Name): APRIL MARIE BASZLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 W MAIN ST
KELSO WA
98626-1118
US

IV. Provider business mailing address

404 W MAIN ST
KELSO WA
98626-1118
US

V. Phone/Fax

Practice location:
  • Phone: 360-423-2806
  • Fax:
Mailing address:
  • Phone: 360-431-1553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: