Individual
RACHAEL MARBLE LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
2424 SW PUMICE AVE, REDMOND, OR 97756-6729
(541) 668-6141
(541) 236-0332
Mailing address
70 SW CENTURY DR STE 100-5038, BEND, OR 97702-3557
(541) 668-6141
(541) 236-0332
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21-12-20128
OR
101YM0800X
Mental Health Counselor
C6420
OR
101YP2500X
Professional Counselor
Primary
C6420
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043638448
NPI1
—
05
—
500672516
—
OR
Enumeration date
04/02/2014
Last updated
02/07/2024
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