Provider Demographics
NPI:1366081085
Name:PROCTOR, HOPE ANN (LICSW-A)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:ANN
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:LICSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 N MARKET BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-2677
Mailing Address - Country:US
Mailing Address - Phone:369-948-0203
Mailing Address - Fax:
Practice Address - Street 1:151 N MARKET BLVD STE C
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-2677
Practice Address - Country:US
Practice Address - Phone:360-948-0203
Practice Address - Fax:360-262-6703
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health