| Blue Iris River Counseling Llc | |
|
2460 4th St Ne Salem OR 97301-8332 | |
| (503) 559-8831 | |
| Not Available |
| Full Name | Blue Iris River Counseling Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2460 4th St Ne, Salem, Oregon |
| Authorized Official Name and Position | Terry Banta (SOCIAL WORKER) |
| Authorized Official Contact | 5035598831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Iris River Counseling Llc 2460 4th St Ne Salem OR 97301-8332 Ph: () - | Blue Iris River Counseling Llc 2460 4th St Ne Salem OR 97301-8332 Ph: (503) 559-8831 |
| NPI Number | 1831817055 |
|---|---|
| Provider Enumeration Date | 08/15/2022 |
| Last Update Date | 08/16/2022 |
| Certification Date | 08/16/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831817055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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