Individual
MIKEL CUMMINGS BOATMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
415 N MORAIN ST, KENNEWICK, WA 99336-2667
(509) 735-6900
(509) 735-6914
Mailing address
415 N MORAIN ST, KENNEWICK, WA 99336-2667
(509) 735-6900
(509) 735-6914
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60011890
WA
Other
Enumeration date
10/25/2007
Last updated
05/13/2020
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