Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CO60966064 | WA |
NPI | 1003476318 |
---|---|
Provider Name | Erin Pickar |
First Address | Aberdeen, WA 98520-4106 |
Second Address | Aberdeen, WA 98520-4106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2019 |
Last Update Date | 18/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO60966064 | (05) | WA |