| Mid-willamette Family And Individual Therapy Services Llc | |
|
698 12th St Se Ste 210 Salem OR 97301-4010 | |
| (971) 757-6640 | |
| Not Available |
| Full Name | Mid-willamette Family And Individual Therapy Services Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 698 12th St Se Ste 210, Salem, Oregon |
| Authorized Official Name and Position | Crissandra Stephen (OWNER) |
| Authorized Official Contact | 9715756640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-willamette Family And Individual Therapy Services Llc 3437 Covington St Ne Salem OR 97305-1507 Ph: (971) 757-6640 | Mid-willamette Family And Individual Therapy Services Llc 698 12th St Se Ste 210 Salem OR 97301-4010 Ph: (971) 757-6640 |
| NPI Number | 1730946542 |
|---|---|
| Provider Enumeration Date | 02/28/2024 |
| Last Update Date | 02/28/2024 |
| Certification Date | 02/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730946542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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