Individual
MRS. CAROL MAE BRIGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
614 DIVISION ST # MS -19, PORT ORCHARD, WA 98366-4614
(360) 337-4625
(360) 337-4704
Mailing address
614 DIVISION ST # MS -19, PORT ORCHARD, WA 98366-4614
(360) 337-4625
(360) 337-4704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001469
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090515
—
WA
Enumeration date
02/21/2020
Last updated
11/27/2023
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