Provider Demographics
NPI:1366578486
Name:INNES, AIMEE WILLOW (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:WILLOW
Last Name:INNES
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 HARRIS AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7002
Mailing Address - Country:US
Mailing Address - Phone:360-920-9229
Mailing Address - Fax:360-671-1673
Practice Address - Street 1:1106 HARRIS AVE STE 304
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7002
Practice Address - Country:US
Practice Address - Phone:360-920-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008140101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health