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Individual

MS. SUE SELF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PEER COUNSELOR

Contact information

Practice address
1302 TACOMA AVE S, SUITE #306, TACOMA, WA 98402-1906
(253) 396-5000
(253) 383-5548
Mailing address
1305 TACOMA AVE S, SUITE#306, TACOMA, WA 98402-1903
(253) 396-5000
(253) 383-5548

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CG60251015
WA

Other

Enumeration date
10/27/2011
Last updated
10/27/2011
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