Jared Scott Detrolio
Counselor in Moses Lake, WA. Individual provider (NPI-1).
NPI number1982170122
StatusActive
Last updated in NPPESOct 15, 2018
Details
- NPI
- 1982170122
- Entity type
- Individual (NPI-1)
- Name
- Jared Scott Detrolio
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 15, 2018
- Last updated
- Oct 15, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | CG60867653 | WA | Yes |
Practice location
840 E Plum StMoses Lake, WA 98837-1874
Phone 509-765-9239 · Fax 509-765-4124
Mailing address
840 E Plum StMoses Lake, WA 98837-1874
Phone 509-765-9239 · Fax 509-765-4124
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 91 Counselor providers in Moses Lake · All 1,082 providers in Moses Lake
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