Individual
JABARI HEAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5710 BEDFORD ST, PASCO, WA 99301-8214
(509) 735-6446
Mailing address
5710 BEDFORD ST, PASCO, WA 99301-8214
(509) 735-6446
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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