| Doctor Name: | MRS. ANGELA NAILLON |
| NPI Number: | 1043681513 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | CG60598946 |
| Business Practice Address: | 2428 West Reynolds Centralia, WA - 98531 |
| Business Phone Number: | 3603309044 |
| Business Fax Number: | 3607363139 |
| Mailing Address: | 2428 West Reynolds, CENTRALIA |
| State: | WA |
| Postal Code: | 98531 |
| Phone Number: | 3603309044 |
| Fax Number: | 3607363139 |
| NPI Enumeration Date: | 10/09/2015 |
| NPI Last Update Date: | 10/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CG60598946 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |