Individual
MR. KYLE CASSINERIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP-T
Contact information
Practice address
515 LAKEWAY DR, BELLINGHAM, WA 98225-5233
(360) 676-2187
Mailing address
515 LAKEWAY DR, BELLINGHAM, WA 98225-5233
(360) 676-2187
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60987309
WA
Other
Enumeration date
10/28/2019
Last updated
10/30/2019
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