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1356624019
MARTY RAY HUCKINS
GILLETTE, WY
NPI
1356624019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY 052)
Enumeration Date
2011-09-20
Last Update Date
2011-09-20
Business Address
Mr. MARTY RAY HUCKINS CAP, CCDC III, ICADC
501 S BURMA AVE
GILLETTE, WY 82716-3426
Phone number: 307-688-5000
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Mailing Address
Mr. MARTY RAY HUCKINS CAP, CCDC III, ICADC
501 SOUTH BURMA AVE.
GILLETTE, WY 82716-3426
Phone number: 307-688-5000
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