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General NPI Number Information
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NPI Number | 1104439934
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Entity Type | Organization
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Legal Business Name | KRISTIN PENN, MA, LMHC (PLLC)
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 170 S LINCOLN ST STE 150
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City | SPOKANE
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State | WA
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Zip | 99201-4443
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Country | US
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Telephone | 206-324-1870
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 DEER LAKE RD, UNIT 1
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City | CLINTON
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State | WA
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Zip | 98236-4005
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Country | US
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Telephone | 206-324-1870
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. KRISTIN PENN
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Credential | MA, LMHC
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Telephone | 206-324-1870
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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 |
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License Number State |
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