Individual
NIKITA DAWN MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
404 W MAIN ST, KELSO, WA 98626-1118
(360) 423-2806
Mailing address
404 W MAIN ST, KELSO, WA 98626-1118
(360) 423-2806
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60743994
WA
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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