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Individual
JEREMY STEVEN AYRES
Active
Individual
JEREMY STEVEN AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHCA, CDPT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC60319918
WA
101YM0800X
Mental Health Counselor
Primary
MC60319918
WA
390200000X
Student in an Organized Health Care Education/Training Program
CO60344511
WA
Other
Enumeration date
01/24/2012
Last updated
09/19/2013
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