Provider Demographics
NPI:1609638501
Name:HOLISTIC DISCOVERY THERAPY, PLLC.
Entity Type:Organization
Organization Name:HOLISTIC DISCOVERY THERAPY, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SELLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHCA
Authorized Official - Phone:206-639-3816
Mailing Address - Street 1:10712 183RD STREET CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-8909
Mailing Address - Country:US
Mailing Address - Phone:206-639-3816
Mailing Address - Fax:
Practice Address - Street 1:10712 183RD STREET CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-8909
Practice Address - Country:US
Practice Address - Phone:206-639-3816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty