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General NPI Number Information
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NPI Number | 1184234718
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Entity Type | Organization
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Legal Business Name | SYNCHRONY PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 100 N MORAIN ST STE 206
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City | KENNEWICK
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State | WA
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Zip | 99336-2905
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Country | US
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Telephone | 509-579-0156
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Fax | 509-491-3112
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Provider Business Mailing Address
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Address Line | 100 N MORAIN ST STE 206
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City | KENNEWICK
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State | WA
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Zip | 99336-2905
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Country | US
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Telephone | 509-579-0156
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Fax | 509-491-3112
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | GARY CHARLES WOLCOTT
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Credential |
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Telephone | 509-579-0156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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