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General NPI Number Information
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NPI Number | 1437122819
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Entity Type | Individual
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Provider Name | COSSETTE D. AHLBORN LMHC
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Gender | Female
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 02/28/2019
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER 9040A FITZSIMMONS
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City | TACOMA
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State | WA
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Zip | 98431-0001
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Country | US
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Telephone | 253-968-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 7035 S LAWRENCE ST
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City | TACOMA
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State | WA
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Zip | 98409-3941
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Country | US
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Telephone | 253-472-4341
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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 | LH00007516
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License Number State | WA
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