Provider Demographics
NPI:1396352951
Name:BOTSFORD, VERONICA ABBOTT (LMT)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:ABBOTT
Last Name:BOTSFORD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33400 9TH AVE S STE 116
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-2607
Mailing Address - Country:US
Mailing Address - Phone:206-486-4805
Mailing Address - Fax:253-295-0778
Practice Address - Street 1:33400 9TH AVE S STE 116
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-2607
Practice Address - Country:US
Practice Address - Phone:206-486-4805
Practice Address - Fax:253-295-0778
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist