Individual
MISS MALIA-ROSE NICOLE FORBIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPEC
Contact information
Practice address
3878 BEVERLY AVE NE BLDG H, SALEM, OR 97305-1394
(503) 576-4584
Mailing address
379 KNOX ST N APT 1, MONMOUTH, OR 97361-1400
(503) 899-5660
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
A4730
OR
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
03/21/2019
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