Doctor Name: | CECILIA REAUME |
NPI Number: | 1881011591 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CO60361166 |
Business Practice Address: | 530 Bogachiel Way Forks, WA - 983319120 |
Business Phone Number: | 3603745011 |
Business Fax Number: | |
Mailing Address: | 530 Bogachiel Way, FORKS |
State: | WA |
Postal Code: | 983319120 |
Phone Number: | 3603745011 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2014 |
NPI Last Update Date: | 03/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CO60361166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |