Individual
THERESE PONCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W., C.S.W.A
Contact information
Practice address
1340 NW WALL ST., BEND, OR 97701-7638
(541) 330-4681
(541) 388-6617
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
A2808
OR
Other
Enumeration date
04/28/2008
Last updated
02/08/2012
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