DWIGHT AUSTIN SERGIO DE LEON

SPOKANE, WA
NPI1811537277
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA  CP61215033)
Enumeration Date2020-01-13
Last Update Date2024-02-02
Business Address
DWIGHT AUSTIN SERGIO DE LEON CP61215033
1302 W GARDNER AVE
SPOKANE, WA 99201-2059
Phone number: 509-503-6010
Mailing Address
DWIGHT AUSTIN SERGIO DE LEON CP61215033
PO BOX 10157
SPOKANE, WA 99209-1157
Phone number: 503-702-8454
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