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1114385119
WILLIE DIEAGO HAABY
ROSEBURG, OR
NPI
1114385119
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 12-12-24)
Enumeration Date
2016-02-04
Last Update Date
2016-02-04
Business Address
Mr. WILLIE DIEAGO HAABY B.S., CADC I
548 SE JACKSON ST
ROSEBURG, OR 97470-2709
Phone number: 541-672-2691
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Mailing Address
Mr. WILLIE DIEAGO HAABY B.S., CADC I
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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