Individual
ADILENNE REVELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6424 N 9TH ST, TACOMA, WA 98406-2091
(253) 565-4484
Mailing address
3911 N 25TH ST APT 521, TACOMA, WA 98406-5339
(253) 353-9634
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SC61242725
WA
Other
Enumeration date
11/20/2018
Last updated
08/06/2024
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