Individual
DIANE G HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
2821 MISSION HILL RD, TULALIP, WA 98271-9706
(360) 716-4306
(360) 716-0863
Mailing address
2821 MISSION HILL RD, TULALIP, WA 98271-9706
(360) 716-4306
(360) 716-0863
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001682
WA
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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