Individual
NICOLE MARIE ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LPC
Contact information
Practice address
9615 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2026
(503) 879-4606
Mailing address
9615 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2026
(503) 879-4606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
IMF 54034
CA
106H00000X
Marriage & Family Therapist
IMF 54034
CA
106H00000X
Marriage & Family Therapist
LMFT77123
CA
106H00000X
Marriage & Family Therapist
Primary
T0986
OR
Other
Enumeration date
04/23/2012
Last updated
10/14/2014
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