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General NPI Number Information
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NPI Number | 1316708555
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Entity Type | Organization
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Legal Business Name | HOLOMIND THERAPY PLLC
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Dates
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Enumeration Date | 01/16/2024
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Last Update Date | 01/16/2024
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Provider Practice Location Address
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Address Line | 1705 E BEAVER LAKE DR SE
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City | SAMMAMISH
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State | WA
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Zip | 98075-7904
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Country | US
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Telephone | 425-245-5025
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 355
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City | FALL CITY
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State | WA
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Zip | 98024-0355
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Country | US
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Telephone | 425-245-5025
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | RACHEL E DAVIS
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Credential | LMHC
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Telephone | 425-245-5025
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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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