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General NPI Number Information
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NPI Number | 1700652336
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Entity Type | Organization
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Legal Business Name | THERAPY WITH SHERESE DANIELLE, LLC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 702 37TH ST SE APT B
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City | AUBURN
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State | WA
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Zip | 98002-8062
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Country | US
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Telephone | 971-770-0724
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Fax |
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Provider Business Mailing Address
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Address Line | 702 37TH ST SE APT B
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City | AUBURN
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State | WA
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Zip | 98002-8062
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Country | US
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Telephone | 971-770-0724
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Fax |
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Authorized Official
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Title or Position | OWNER/MENTAL HEALTH THERAPIST
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Name | SHERESE EZELLE
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Credential | LMHC, LPC
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Telephone | 971-770-0724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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