Individual
MR. MARTY RAY HUCKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAP, CCDC III, ICADC
Contact information
Practice address
501 S BURMA AVE, GILLETTE, WY 82716-3426
(307) 688-5000
(307) 688-5015
Mailing address
501 SOUTH BURMA AVE., GILLETTE, WY 82716-3426
(307) 688-5000
(307) 688-5015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
052
WY
Other
Enumeration date
09/20/2011
Last updated
09/20/2011
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