Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CP60235502 | WA |
NPI | 1003262957 |
---|---|
Provider Name | Bev J Carman |
First Address | Oak Harbor, WA 98277-9701 |
Second Address | Oak Harbor, WA 98277-9701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2016 |
Last Update Date | 10/05/2016 |