Individual
ANGELINE DOMINIQUE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
821 SAGINAW ST S, SALEM, OR 97302-4121
(503) 315-8646
Mailing address
30323 S BRUCE TOMLIN ST, MOLALLA, OR 97038-7624
(503) 654-3400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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