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1356875371
DAN FAGERNESS
CENTRALIA, WA
NPI
1356875371
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2017-04-17
Last Update Date
2017-04-17
Business Address
DAN FAGERNESS
2428 W REYNOLDS AVE
CENTRALIA, WA 98531-4554
Phone number: 360-330-9044
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Mailing Address
DAN FAGERNESS
2428 W REYNOLDS AVE
CENTRALIA, WA 98531-4554
Phone number: 360-330-9044
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