Jared Scott Detrolio Valid NPI
Individual provider · Counselor · Moses Lake, WA
- NPI
- 1982170122
- Type
- Individual (Type 1)
- Primary specialty
- Counselor
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101Y00000X
- License number
- CG60867653 (WA)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2018-10-15
- Last updated
- 2018-10-15
Practice location
840 E Plum St
Moses Lake, WA 98837-1874
(509) 765-9239