Individual
REBECCA SOUPIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1612 5TH ST, LA GRANDE, OR 97850-2516
(541) 975-4488
Mailing address
2206 1ST ST, LA GRANDE, OR 97850-1705
(541) 975-4488
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11387
OR
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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