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Individual
JOHNATHAN SAMUEL DETWILER
Active
Individual
JOHNATHAN SAMUEL DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39003508A
IN
101YM0800X
Mental Health Counselor
C5666
OR
101YM0800X
Mental Health Counselor
Primary
LH61055500
WA
Other
Enumeration date
03/10/2019
Last updated
09/23/2025
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