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Individual
MARK HENRY
Active
Individual
MARK HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C1433
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C1433
OREGON BOARD OF LICENSED PROFESSIONAL COUNSELORS
OR
Enumeration date
01/07/2009
Last updated
06/06/2016
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