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Individual
SIMON S TEDROW
Active
Individual
SIMON S TEDROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60215848
WA
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/11/2016
Last updated
11/21/2022
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