Individual
BONNIE KAY GILLISPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP - TRAINEE
Contact information
Practice address
710 SW ROCK CREEK DR., STEVENSON, WA 98648
(509) 427-3850
(509) 427-0188
Mailing address
PO BOX 369, STEVENSON, WA 98648
(509) 427-3850
(509) 427-0188
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CG60451727
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60474384
WA
Other
Enumeration date
02/02/2015
Last updated
05/11/2015
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