Individual
BREE ANA BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDP, MHP
Contact information
Practice address
1601 E 4TH PLAIN BLVD BLDG 17, VANCOUVER, WA 98661-3717
(360) 397-8246
Mailing address
6050 41ST AVE SW, SEATTLE, WA 98136-1606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60417920
WA
101YM0800X
Mental Health Counselor
CG61055353
WA
Other
Enumeration date
04/23/2021
Last updated
09/01/2021
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