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Organization
ABRI RADICALLY OPEN DBT LLC
Active
Organization
ABRI RADICALLY OPEN DBT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LI LIN HALLY LCSW (CLINICAL DIRECTOR)
(503) 267-4786
Entity
Organization
Contact information
Practice address
520 SW YAMHILL ST STE 345, PORTLAND, OR 97204-1335
(503) 267-4786
Mailing address
520 SW YAMHILL ST STE 345, PORTLAND, OR 97204-1335
(503) 267-4786
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/07/2019
Last updated
02/07/2019
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