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General NPI Number Information
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NPI Number | 1962930446
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Entity Type | Organization
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Legal Business Name | RESILIENT THERAPY
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 05/30/2017
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Provider Practice Location Address
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Address Line | 624 W HASTINGS RD STE 9
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City | SPOKANE
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State | WA
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Zip | 99218-2877
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Country | US
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Telephone | 509-219-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 11310 N ANNA J DR
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City | SPOKANE
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State | WA
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Zip | 99218-2701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA ADAMS
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Credential |
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Telephone | 509-219-0030
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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 | LW60512888
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License Number State | WA
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