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Individual

TAYLOR CARLSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5052
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
74257
ND
Enumeration date
09/12/2014
Last updated
07/21/2022
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