MARY L HAGSTROM

COLVILLE, WA
NPI1538238191
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP00001268)
Enumeration Date2006-11-07
Last Update Date2007-07-08
Business Address
-- MARY L HAGSTROM CDP
165 E HAWTHORNE AVE
COLVILLE, WA 99114-2629
Phone number: 509-684-4597
Mailing Address
-- MARY L HAGSTROM CDP
613 W MAIN AVE
CHEWELAH, WA 99109-9146
Phone number: 509-935-0866
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