Perinatal Support Washington

Thank you for applying to be on our provider list. In order to be listed you must meet the following requirements
* 12 CEUs in Perinatal Mental Health (5 for non mental health professionals)
* 2 years in practice
* Up to date and licensed in your field
(If you are working towards these requirements, you are welcome to complete this application and we will keep your info on file.)
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    Personal Information

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    Practice Information

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    Requirements to remain on our provider lists:

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