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Organization
THE MOM EVOLUTION
Active
Organization
THE MOM EVOLUTION
Active
Other names
The Mom Evolution
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADELINE HOLTER LCSW, LAC (THERAPIST AND OWNER)
(877) 831-1535
Entity
Organization
Contact information
Practice address
45 NW GREELEY AVE, BEND, OR 97703-2943
(877) 831-1535
Mailing address
45 NW GREELEY AVE, BEND, OR 97703-2943
(877) 831-1535
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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