Samantha Joann Wynn, SUDPT

NPI #1720628167 in Cusick, Washington

Provider Information

NPI Number: 1720628167
Entity Type: Individual
Name: Samantha Joann Wynn, SUDPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Credential: SUDPT
Enumeration Date: Jan 14, 2020
Last Updated: Jan 14, 2020

Practice Location

Address: 808 COMMUNITY HALL RD
City: Cusick
State: Washington
ZIP Code: 99119-6034
Phone: (509) 447-7193

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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