| Rising Moon Therapy, Llc | |
|
375 Park Ave Ste 2 Coos Bay OR 97420-2242 | |
| (541) 435-0304 | |
| (541) 394-4142 |
| Full Name | Rising Moon Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 375 Park Ave Ste 2, Coos Bay, Oregon |
| Authorized Official Name and Position | Johanna Curelo (OWNER/LICENSED PROF. COUNSELOR) |
| Authorized Official Contact | 5414350304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Moon Therapy, Llc Po Box 426 Coos Bay OR 97420-0048 Ph: (541) 435-0304 | Rising Moon Therapy, Llc 375 Park Ave Ste 2 Coos Bay OR 97420-2242 Ph: (541) 435-0304 |
| NPI Number | 1699409623 |
|---|---|
| Provider Enumeration Date | 07/14/2022 |
| Last Update Date | 07/14/2022 |
| Certification Date | 07/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699409623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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