Individual
DEBRA MAE HAWORTH-BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC,CPRC,CPSS,CFSP
Contact information
Practice address
30410 HIGHWAY 200 STE 200, PONDERAY, ID 83852-9601
(208) 263-7101
Mailing address
PO BOX 2160, SANDPOINT, ID 83864-0908
(208) 263-7101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12953
ID
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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