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1356062129
ALEX LEE BACCUS
CENTRALIA, WA
NPI
1356062129
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Additional Taxonomies
101YM0800X Counselor Mental Health
Enumeration Date
2022-09-08
Last Update Date
2022-09-08
Business Address
ALEX LEE BACCUS
1707 COOKS HILL RD
CENTRALIA, WA 98531-9071
Phone number: 360-523-8396
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Mailing Address
ALEX LEE BACCUS
1707 COOKS HILL RD
CENTRALIA, WA 98531-9071
Phone number: 360-523-8396
Copy
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