Individual
MISS BRYANNA JO SQUIBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HM60795744
Contact information
Practice address
3510 STEELHAMMER DR, CENTRALIA, WA 98531-4551
(360) 623-8020
Mailing address
83 SW 10TH ST, CHEHALIS, WA 98532-4704
(360) 269-3856
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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