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1023642659
CAROL MAE BRIGHAM
PORT ORCHARD, WA
NPI
1023642659
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP00001469)
Enumeration Date
2020-02-21
Last Update Date
2023-11-27
Business Address
Mrs. CAROL MAE BRIGHAM SUDP
614 DIVISION ST # MS -19
PORT ORCHARD, WA 98366-4614
Phone number: 360-337-4625
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Mailing Address
Mrs. CAROL MAE BRIGHAM SUDP
614 DIVISION ST # MS -19
PORT ORCHARD, WA 98366-4614
Phone number: 360-337-4625
Copy
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