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Individual

BRIAN MIZOGUCHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CDP

Contact information

Practice address
5921 N MARKET ST, SPOKANE, WA 99208-2484
(509) 487-1604
(509) 482-6286
Mailing address
203 N WASHINGTON ST STE 300, SPOKANE, WA 99201-0233
(509) 444-8888
(509) 444-7806

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60145164
WI

Other

Enumeration date
03/21/2012
Last updated
03/21/2012
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