Individual
KIMBERLY MANTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP60821274
Contact information
Practice address
9601 BUJACICH RD NW, GIG HARBOR, WA 98332-8300
(360) 440-2949
Mailing address
1061 EAGLE CREST PL, PORT ORCHARD, WA 98366-3632
(360) 440-2949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60821274
WA
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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