Individual
DESIREE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
149 N MAIN ST, PHOENIX, OR 97535
(541) 535-4133
Mailing address
149 N MAIN ST., PHOENIX, OR 97535
(541) 210-3527
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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