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General NPI Number Information
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NPI Number | 1780493502
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Entity Type | Organization
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Legal Business Name | KUWAYE COUNSELING
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 42010 MARKS RIDGE DR
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City | SWEET HOME
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State | OR
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Zip | 97386-9545
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Country | US
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Telephone | 541-409-6377
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Fax |
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Provider Business Mailing Address
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Address Line | 42010 MARKS RIDGE DR
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City | SWEET HOME
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State | OR
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Zip | 97386-9545
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Country | US
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Telephone | 541-409-6377
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/OPERATOR
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Name | MR. KEONI YUTAKA DANIELSON KUWAYE
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Credential |
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Telephone | 541-409-6377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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