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1871370841
DUSTIN MARTIN AVILA
TACOMA, WA
NPI
1871370841
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA 61472800)
Enumeration Date
2023-09-12
Last Update Date
2023-09-12
Business Address
DUSTIN MARTIN AVILA SUDP-T
3209 N 7TH ST
TACOMA, WA 98406-5905
Phone number: 408-310-2062
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Mailing Address
DUSTIN MARTIN AVILA SUDP-T
3209 N 7TH ST
TACOMA, WA 98406-5905
Phone number: 408-310-2062
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