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1811537277
DWIGHT AUSTIN SERGIO DE LEON
SPOKANE, WA
NPI
1811537277
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP61215033)
Enumeration Date
2020-01-13
Last Update Date
2024-02-02
Business Address
DWIGHT AUSTIN SERGIO DE LEON CP61215033
1302 W GARDNER AVE
SPOKANE, WA 99201-2059
Phone number: 509-503-6010
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Mailing Address
DWIGHT AUSTIN SERGIO DE LEON CP61215033
PO BOX 10157
SPOKANE, WA 99209-1157
Phone number: 503-702-8454
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