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Individual

PRISCILLA KLOCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
712 SE HAWTHORNE BLVD, SUITE 100, PORTLAND, OR 97214-3538
(503) 954-2188
(503) 327-8005
Mailing address
712 SE HAWTHORNE BLVD, SUITE 100, PORTLAND, OR 97214-3538
(503) 954-2188
(503) 327-8005

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
OR

Other

Enumeration date
04/28/2011
Last updated
04/28/2011
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