| Brainbow Forge | |
|
137 Hall Ave Coos Bay OR 97420-1519 | |
| (541) 229-7879 | |
| Not Available |
| Full Name | Brainbow Forge |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 137 Hall Ave, Coos Bay, Oregon |
| Authorized Official Name and Position | Mariena Joy (THERAPIST) |
| Authorized Official Contact | 5412297879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brainbow Forge 137 Hall Ave Coos Bay OR 97420-1519 Ph: () - | Brainbow Forge 137 Hall Ave Coos Bay OR 97420-1519 Ph: (541) 229-7879 |
| NPI Number | 1659119030 |
|---|---|
| Provider Enumeration Date | 07/18/2024 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659119030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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