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Organization
STILL WATERS COUNSELING
Active
Organization
STILL WATERS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO CLIFTON LONG-DREW REGISTERED LPC INTER (OWNER/OPERATOR)
(541) 561-8127
Entity
Organization
Contact information
Practice address
442 NW WADE STREET, ESTACADA, OR 97023
(541) 561-8127
Mailing address
442 NW WADE ST, ESTACADA, OR 97023-9744
(541) 561-8127
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R4884
OR
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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