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Agencies at Canal Dr, Kennewick, WA

License number
Washington 03060500
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: MR. ROBERT GLENN LACK III MA, CDP, CL
Title: ADMINISTRATOR
Phone: (509) 735-7410
Address
Address
4911 W Canal Dr, Kennewick, WA 99336
National Provider ID: 1205241106
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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