Individual
HILARY GWEN DON'T MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAC, SUDPT
Contact information
Practice address
900 FIR ST, LONGVIEW, WA 98632-2544
(360) 575-3316
(360) 423-7813
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 575-3316
(360) 423-7813
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO61424315
WA
175T00000X
Peer Specialist
Primary
CG61315486
WA
Other
Enumeration date
07/18/2022
Last updated
07/11/2023
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