Individual
KA'NYSHA LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3640 S CEDAR ST STE M, TACOMA, WA 98409-5700
(253) 478-0827
Mailing address
3640 S CEDAR ST STE M, TACOMA, WA 98409-5700
(253) 478-0827
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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