Individual
KAMIMSA JOSEPHINE GOUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 575-4084
Mailing address
1221 QUEEN AVE, YAKIMA, WA 98902-5418
(509) 910-2848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO61438615
WA
171M00000X
Case Manager/Care Coordinator
Primary
—
WA
Other
Enumeration date
06/15/2023
Last updated
08/14/2024
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