person
Stacy Raeann Wirkkala, SUDPT
Addiction (Substance Use Disorder) Counselor in Kelso, Washington
NPI 1144973223

Stacy Raeann Wirkkala is an Addiction (Substance Use Disorder) Counselor based in Longview, WA and is specialized in Addiction (Substance Use Disorder). Stacy Raeann Wirkkala practices in Kelso, WA and has the professional credentials of SUDPT. The NPI Number for Stacy Raeann Wirkkala is 1144973223 and holds a License No. CO61077791 (Washington).

The current practice location address for Stacy Raeann Wirkkala is 404 W Main St, Kelso, WA and can be reached out via phone at 360-423-2806.

Location: 404 W Main St, Kelso, WA, 98632-9147
person
Provider Profile Details
NPI Number
1144973223
Provider Name
Stacy Raeann Wirkkala
Credential
SUDPT
Provider Entity Type
Individual
Gender
Female
Address
404 W Main St, Kelso, WA, 98632-9147
Phone Number
360-423-2806
Fax Number
Provider Enumeration Date
01/30/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
404 W Main St
City
State
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
person
Provider Business Mailing Address Details
Address
404 W Main St
City
State
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CO61077791 (Washington)
Definition
Definition to come...
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