Individual
SAMUEL WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
139 CORNELL ST, KINGSTON, NY 12401-3633
(845) 338-1234
Mailing address
1 HOMESTEAD CT, WALDEN, NY 12586-3414
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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