Provider Demographics
NPI:1891317467
Name:PICARDAL, MARY ROSE TOLEDO (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:MARY ROSE
Middle Name:TOLEDO
Last Name:PICARDAL
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22904 40TH PL W
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-5002
Mailing Address - Country:US
Mailing Address - Phone:206-369-0439
Mailing Address - Fax:
Practice Address - Street 1:22904 40TH PL W
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5002
Practice Address - Country:US
Practice Address - Phone:206-369-0439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-17
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA608959891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical