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General NPI Number Information
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NPI Number | 1083899652
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Entity Type | Individual
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Provider Name | STEPHANIE ALLISON DRAKE MSW, MA
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Gender | Female
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 547 DAYTON ST
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City | EDMONDS
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State | WA
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Zip | 98020-3431
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Country | US
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Telephone | 425-771-5116
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 MARKET PL A-203
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City | EVERETT
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State | WA
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Zip | 98205-1552
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Country | US
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Telephone | 425-478-0368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | RC00059868
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License Number State | WA
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