RAVEN HERZOG

Counselor

Active Individual
NPI: 1104271295

Practice Address

720 14TH AVE
Longview, WA 98632

Phone: (360) 423-0203

Specialties

Specialty Code Primary License
Behavior Analyst 103K00000X No -
Counselor 101Y00000X Yes -

Frequently Asked Questions

NPI 1104271295 is the National Provider Identifier for RAVEN HERZOG, a Counselor provider located in Longview, WA. This NPI was enumerated on April 26, 2016.
RAVEN HERZOG practices at 720 14TH AVE, Longview, WA 98632.

Quick Facts

NPI
1104271295
Type
Individual
Enumerated
Apr 26, 2016
Last Updated
Jan 14, 2020

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