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Individual
WAYDE JENNINGS WASHBURN
Active
Individual
WAYDE JENNINGS WASHBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAC II, NCAC I
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
012692
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0858
GA
Other
Enumeration date
03/31/2011
Last updated
04/30/2014
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