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Khadija Tahira Ewalt
Mental Health Counselor in Centralia, Washington
NPI 1851939474

Khadija Tahira Ewalt is a Mental Health Counselor based in Centralia, WA and is specialized in Mental Health. Khadija Tahira Ewalt practices in Centralia, WA. The NPI Number for Khadija Tahira Ewalt is 1851939474 and holds a License No. (Washington).

The current practice location address for Khadija Tahira Ewalt is 3510 Steelhammer Dr, Centralia, WA and can be reached out via phone at 360-623-8020.

Location: 3510 Steelhammer Dr, Centralia, WA, 98531-4551
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851939474
Provider Name
Khadija Tahira Ewalt
Credential
Provider Entity Type
Individual
Gender
Female
Address
3510 Steelhammer Dr, Centralia, WA, 98531-4551
Phone Number
360-623-8020
Fax Number
Provider Enumeration Date
12/13/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3510 Steelhammer Dr
City
Centralia
State
Washington
Zip
98531-4551
Phone Number
360-623-8020
Fax Number
person
Provider Business Mailing Address Details
Address
3510 Steelhammer Dr
City
Centralia
State
Washington
Zip
98531-4551
Phone Number
360-623-8020
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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