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1629120274
MARY L LAVILLE
NEWPORT, WA
NPI
1629120274
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-01-16
Last Update Date
2007-07-08
Business Address
-- MARY L LAVILLE
105 SOUTH GARDEN AVE
NEWPORT, WA 99156-5055
Phone number: 509-447-5651
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Mailing Address
-- MARY L LAVILLE
PO BOX 5055
NEWPORT, WA 99156-5055
Phone number: 509-447-5651
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