Individual
SHANNON MARIA BAULNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Mailing address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
(509) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60213855
WA
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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