Basic Information
| Provider Information | |||||||||
| NPI: | 1629171087 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KIEHL | ||||||||
| FirstName: | MONICA | ||||||||
| MiddleName: | DENISE | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2522 N PROCTOR ST # 428 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984065338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535828440 | ||||||||
| FaxNumber: | 2535894166 | ||||||||
| Practice Location | |||||||||
| Address1: | VAPSHCS-AMERICAN LAKE | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535828440 | ||||||||
| FaxNumber: | 2535894166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LW00005114 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.