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Individual
EDWARD DEHERRERA
Active
Individual
EDWARD DEHERRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
C061261876
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO61261876
INSURANCE BILLING
WA
Enumeration date
04/11/2022
Last updated
04/11/2022
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