Individual
PATRICIA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
185 NE 4TH ST STE 5, PRINEVILLE, OR 97754-1934
(971) 312-2091
Mailing address
1068 NE LOOKOUT AVE, PRINEVILLE, OR 97754-1317
(971) 312-2091
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C5788
OR
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124440813
NPI
OR
Enumeration date
01/14/2014
Last updated
03/12/2021
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