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Individual

BRIAN TELLERIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
14407 E OLYMPIC AVE, SPOKANE, WA 99216
(208) 861-1318
Mailing address
PO BOX 3648, COEUR D ALENE, ID 83816-2522

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60871464
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LH60871464
WA LICENSE
WA
Enumeration date
11/05/2014
Last updated
08/12/2022
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