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General NPI Number Information
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NPI Number | 1740881564
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Entity Type | Organization
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Legal Business Name | ADAPT TO GROWTH THERAPY, PLLC
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 406 MAIN ST STE 102A
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City | EDMONDS
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State | WA
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Zip | 98020-3166
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Country | US
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Telephone | 206-561-5895
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Fax |
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Provider Business Mailing Address
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Address Line | 309 NW 55TH ST
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City | SEATTLE
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State | WA
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Zip | 98107-2705
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Country | US
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Telephone | 206-561-5895
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Fax |
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Authorized Official
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Title or Position | CHILD AND FAMILY THERAPIST
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Name | KARLA T MANCERO
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Credential | LMFT
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Telephone | 410-561-5895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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