Provider Demographics
NPI:1902226111
Name:RUMBLE, LAREE (MED, LMHC)
Entity Type:Individual
Prefix:
First Name:LAREE
Middle Name:
Last Name:RUMBLE
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 AUTUMN PL
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-4084
Mailing Address - Country:US
Mailing Address - Phone:509-679-2380
Mailing Address - Fax:
Practice Address - Street 1:2030 AUTUMN PL
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-4084
Practice Address - Country:US
Practice Address - Phone:509-679-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-27
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60296884101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional