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Dawn Street, MA, LEFT Licensed Marriage and Family Therapist 611 Columbia St. NW Suite 2A Olympia, WA 98501 3607051492 www.dawnstremel.comCHILD/YOUTH MOOD & BEHAVIOR RATING SCALE Youth Name: Age:
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Dawn Stremel MA LMFT is a licensed marriage and family therapist.
Marriage and family therapists who are licensed and practicing in the field.
The form can be filled out online or submitted in paper form following the instructions provided by the licensing board.
The purpose is to maintain accurate records of practicing marriage and family therapists for regulatory and public safety purposes.
Personal information, licensure status, practice details, and any disciplinary actions taken against the therapist.
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