Individual provider · Type 1 NPI
Leon Douglas Eagle Tail, MSW, CDP
Addiction (Substance Use Disorder) Counselor · Spokane Valley, WA
NPI number
1780878694
Active
Practice location
224 N Willow Rd
Spokane Valley, WA 99206-6812
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | RC00025859 (WA) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | CP00004360 (WA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1780878694
Leon Douglas Eagle Tail, MSW, CDP's National Provider Identifier is 1780878694, issued on Sep 4, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Spokane Valley, WA. The record was last updated on Sep 4, 2007.