Provider Demographics
NPI:1336541747
Name:DE LA TORRE, EMILY KAY (MS, NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:KAY
Last Name:DE LA TORRE
Suffix:
Gender:F
Credentials:MS, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W 12TH WAY
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:WA
Mailing Address - Zip Code:98629-4267
Mailing Address - Country:US
Mailing Address - Phone:360-619-2275
Mailing Address - Fax:
Practice Address - Street 1:601 MAIN ST STE 503
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3414
Practice Address - Country:US
Practice Address - Phone:360-619-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2017-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health