Individual
HAILEY SAMUDIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Contact information
Practice address
17 E 1ST AVE, SPOKANE, WA 99202-1501
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61442633
WA
104100000X
Social Worker
Primary
SC61506928
WA
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
09/05/2023
Last updated
07/09/2024
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