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1649058009
KIWANI MACK
SPOKANE, WA
NPI
1649058009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2023-09-18
Last Update Date
2023-09-18
Business Address
KIWANI MACK
910 W BOONE AVE
SPOKANE, WA 99201-5029
Phone number: 509-325-7232
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Mailing Address
KIWANI MACK
4914 N VISTA VIEW CIR
SPOKANE, WA 99212-1608
Phone number: 509-270-2333
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