Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CO60700665 | WA |
NPI | 1003354259 |
---|---|
Provider Name | Leticia Cuevas |
First Address | Vancouver, WA 98661-3713 |
Second Address | Vancouver, WA 98661-3713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 08/02/2017 |