Individual
MRS. TIANA PETIT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LMHC
Contact information
Practice address
2306 NE GLISAN ST, PORTLAND, OR 97232-2392
(971) 998-6080
Mailing address
3415 NE 44TH AVE, PORTLAND, OR 97213-1140
(971) 998-6080
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60586515
WA
103TC1900X
Counseling Psychologist
Primary
C4006
OR
Other
Enumeration date
05/17/2013
Last updated
11/16/2019
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