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Individual

BRETT D WILLCOCKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SUDPT

Contact information

Practice address
1321 N ASH ST, SPOKANE, WA 99201-2803
(509) 327-3120
Mailing address
1321 N ASH ST, SPOKANE, WA 99201-2803
(509) 327-3120

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60455856
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077844
WA
Enumeration date
09/17/2019
Last updated
01/29/2020
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