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1194595926
MALISSA KAUTZ
TACOMA, WA
NPI
1194595926
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA CO61248684)
Enumeration Date
2024-01-03
Last Update Date
2024-01-03
Business Address
MALISSA KAUTZ CO61248684
4301 S PINE ST STE 92
TACOMA, WA 98409-7259
Phone number: 253-507-5334
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Mailing Address
MALISSA KAUTZ CO61248684
11127 10TH AVENUE CT E APT A303
PARKLAND, WA 98445-7081
Phone number: 253-592-4509
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