Provider Demographics
NPI:1245632868
Name:REFF, CALLIE
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:REFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 N TRUMPETER DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-8968
Mailing Address - Country:US
Mailing Address - Phone:360-540-2265
Mailing Address - Fax:
Practice Address - Street 1:2221 N TRUMPETER DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-8968
Practice Address - Country:US
Practice Address - Phone:360-540-2265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60457038101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor