Individual provider · Type 1 NPI

Licia Monique Emanuel-Moffett, CDPT

Addiction (Substance Use Disorder) Counselor · Longview, WA

NPI number 1184112294 Active

Practice location

720 14th Ave
Longview, WA 98632-2315

Call (360) 423-0203 Map

Fax (360) 423-5086

Mailing address

921 14th Ave
Longview, WA 98632-2316

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X60811079 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1184112294

Licia Monique Emanuel-Moffett, CDPT's National Provider Identifier is 1184112294, issued on Apr 24, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Longview, WA. The record was last updated on Apr 24, 2018.