Individual
CASSANDRA SUSANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
10828 GRAVELLY LAKE DR. SW, SUITE 204, LAKEWOOD, WA 98499
(253) 473-7474
(253) 474-9724
Mailing address
10828 GRAVELLY LAKE DR. SW, SUITE 204, LAKEWOOD, WA 98499
(253) 473-7474
(253) 474-9724
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60316800
WA
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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