| Blue Libelula Inc | |
|
2509 1st St Baker City OR 97814-2301 | |
| (818) 579-2156 | |
| (541) 239-5506 |
| Full Name | Blue Libelula Inc |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 2509 1st St, Baker City, Oregon |
| Authorized Official Name and Position | Guadalupe Kirklin (PRESIDENT / OWNER) |
| Authorized Official Contact | 8057019894 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Libelula Inc Po Box 865 Baker City OR 97814-0865 Ph: (818) 579-2156 | Blue Libelula Inc 2509 1st St Baker City OR 97814-2301 Ph: (818) 579-2156 |
| NPI Number | 1003490590 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 02/07/2024 |
| Certification Date | 02/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003490590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
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