Individual
MAVERICK MIRIAM TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
515 LAKEWAY DR, BELLINGHAM, WA 98225-5233
(360) 676-2187
Mailing address
1610 LINCOLN ST APT 3, BELLINGHAM, WA 98229-6252
(206) 453-8501
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60993506
WA
Other
Enumeration date
04/05/2017
Last updated
08/22/2019
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