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Individual

ELENA 'ELLE' HAZLEWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDPT

Contact information

Practice address
910 16TH AVE STE 120, LONGVIEW, WA 98632-2374
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
61419838
WA

Other

Enumeration date
07/18/2023
Last updated
07/18/2023
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