TOMAS D MINO PENA

CHEHALIS, WA
NPI1003472440
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  1376696096)
Enumeration Date2019-05-10
Last Update Date2019-05-24
Business Address
TOMAS D MINO PENA CDPT60922995
151 N MARKET BLVD STE C
CHEHALIS, WA 98532-2677
Phone number: 360-948-0203
Mailing Address
TOMAS D MINO PENA CDPT60922995
121 NW CHEHALIS AVE
CHEHALIS, WA 98532-2010
Phone number: 360-948-0203
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