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1376214247
MINDY LORRAINE TAITANO
KELSO, WA
NPI
1376214247
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Former Name
MINDY LORRAINE WILSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-09-21
Last Update Date
2021-09-21
Business Address
Mrs. MINDY LORRAINE TAITANO
305 PACIFIC AVE S STE C
KELSO, WA 98626-1638
Phone number: 360-356-7775
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Mailing Address
Mrs. MINDY LORRAINE TAITANO
305 PACIFIC AVE S STE C
KELSO, WA 98626-1638
Phone number: 360-353-7775
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