Individual
SALLY ANN HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
11910 NE 154TH ST, BRUSH PRAIRIE, WA 98606-9571
(360) 750-9588
(360) 750-9718
Mailing address
11910 NE 154TH ST, BRUSH PRAIRIE, WA 98606-9571
(360) 750-9588
(360) 750-9718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60903587
WA
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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