Santa Selena Martin-Bautista, SUDPT
Counselor in Shelton, WA. Individual provider (NPI-1).
NPI number1710694450
StatusActive
Last updated in NPPESNov 2, 2022
Details
- NPI
- 1710694450
- Entity type
- Individual (NPI-1)
- Name
- Santa Selena Martin-Bautista
- Credential
- SUDPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 2, 2022
- Certification date
- Nov 2, 2022
- Last updated
- Nov 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | 61358497 | WA | Yes |
Practice location
506 W. Franklin StreetShelton, WA 98584-3517
Phone 360-427-5232 · Fax 360-427-5006
Mailing address
Po Box 59Chehalis, WA 98532
Phone 360-740-4380 · Fax 360-740-1877
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