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1174355499
MIRANDA JAKSHA
LONGVIEW, WA
NPI
1174355499
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 61491028)
Enumeration Date
2024-08-15
Last Update Date
2024-08-15
Business Address
Mrs. MIRANDA JAKSHA SUDP-T
900 FIR ST
LONGVIEW, WA 98632-2544
Phone number: 360-353-9422
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Mailing Address
Mrs. MIRANDA JAKSHA SUDP-T
PO BOX 2429
LONGVIEW, WA 98632-8486
Phone number:
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