Individual
DUSTY RALYNN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 PACIFIC AVE S STE 102, KELSO, WA 98626-1638
(360) 577-7442
(360) 577-7904
Mailing address
PO BOX 1847, LONGVIEW, WA 98632
(360) 423-0203
(360) 577-0269
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
60490075
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/16/2018
Last updated
11/21/2019
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