Provider Demographics
NPI:1093336372
Name:COLVIN, GINGER ANN (CDPT)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:ANN
Last Name:COLVIN
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-2803
Mailing Address - Country:US
Mailing Address - Phone:509-327-3120
Mailing Address - Fax:509-327-3228
Practice Address - Street 1:218 N OAK ST STE B
Practice Address - Street 2:
Practice Address - City:COLVILLE
Practice Address - State:WA
Practice Address - Zip Code:99114-2968
Practice Address - Country:US
Practice Address - Phone:509-684-5867
Practice Address - Fax:509-684-1925
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty