Provider Demographics
NPI:1912498031
Name:DUGUAY, JOANNA (CDPT)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:DUGUAY
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:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:WELLPINIT
Mailing Address - State:WA
Mailing Address - Zip Code:99040-0540
Mailing Address - Country:US
Mailing Address - Phone:509-258-7502
Mailing Address - Fax:509-258-4480
Practice Address - Street 1:6228 E OLD SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WELLPINIT
Practice Address - State:WA
Practice Address - Zip Code:99040-0540
Practice Address - Country:US
Practice Address - Phone:509-258-7502
Practice Address - Fax:509-258-4480
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60801985101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)