Individual
SASHA ELISE MBOLEKWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPC
Contact information
Practice address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61376274
WA
175T00000X
Peer Specialist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101Y00000X
COUNSELOR - LICENSE: CG61376274
WA
01
—
175T00000X
PEER SPECIALIST
WA
Enumeration date
03/02/2023
Last updated
03/02/2023
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