Individual
MR. BENJAMIN THEODORE DESCOTEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
1007 KOALA AVE, OMAK, WA 98841-9247
(509) 826-6191
(509) 826-8560
Mailing address
1007 KOALA AVE, OMAK, WA 98841-9247
(509) 826-6191
(509) 826-8560
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
RC00030840
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00001300
WA
101YM0800X
Mental Health Counselor
Primary
LH00009254
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980812
—
WA
Enumeration date
08/30/2006
Last updated
11/11/2008
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