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Individual

DAXEA DEWEESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSW, CDAC-I

Contact information

Practice address
2105 CAPURRO WAY STE 105, SPARKS, NV 89431-8586
(775) 455-4260
Mailing address
2105 CAPURRO WAY STE 105, SPARKS, NV 89431-8586

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
02292-I
NV
104100000X
Social Worker
Primary
7635-S
NV

Other

Enumeration date
02/27/2018
Last updated
02/27/2018
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