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General NPI Number Information
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NPI Number | 1629637103
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Entity Type | Organization
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Legal Business Name | WHOLE VALLEY THERAPY, PLLC
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Dates
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Enumeration Date | 06/10/2019
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 15315 1ST AVE NE STE 216
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City | DUVALL
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State | WA
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Zip | 98019-5005
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Country | US
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Telephone | 206-612-3120
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 816
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City | DUVALL
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State | WA
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Zip | 98019-0816
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Country | US
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Telephone | 425-780-6227
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/THERAPIST
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Name | DANIELLE WINTERWOOD
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Credential | MSW, LICSW
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Telephone | 425-780-6227
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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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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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