Raven Herzog
NPI #1104271295 in Longview, Washington
Provider Information
- NPI Number
- 1104271295
- Entity Type
- Individual
- Name
- Raven Herzog
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Apr 26, 2016
- Last Updated
- Jan 14, 2020
Practice Location
- Address
- 720 14TH AVE
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-2315
- Phone
- (360) 423-0203
Specialties & Taxonomy Codes
| Specialty |
|---|
| Behavior Analyst |
| Counselor |
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