Licia Monique Emanuel-Moffett, CDPT
NPI #1184112294 in Longview, Washington
Provider Information
- NPI Number
- 1184112294
- Entity Type
- Individual
- Name
- Licia Monique Emanuel-Moffett, CDPT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Addiction (Substance Use Disorder)
- Credential
- CDPT
- Enumeration Date
- Apr 24, 2018
- Last Updated
- Apr 24, 2018
Practice Location
- Address
- 720 14TH AVE
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-2315
- Phone
- (360) 423-0203
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder) |
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