Individual
SHANNAN D HEADRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 NW CHEHALIS AVE, CHEHALIS, WA 98532-2010
(360) 740-9767
(360) 740-5484
Mailing address
PO BOX 1371, CHEHALIS, WA 98532-0340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60904459
WA
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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