Individual
ALLICA AYRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6005 TYEE DR SW, TUMWATER, WA 98512-7356
(360) 464-6867
Mailing address
15025 TAHOMA BLVD SE APT C202, YELM, WA 98597-7764
(951) 505-2592
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61556977
WA
Other
Enumeration date
01/19/2017
Last updated
06/25/2024
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