Individual
WINONA CASANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
202 CULLENS ST NW, YELM, WA 98597-9417
(360) 400-4860
(360) 400-4826
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60011979
WA
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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