Organization
EVOLVING SELF INTEGRAL COUNSELING, LLC
Active
Other names
Evolving Self Integral Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
PALMA AZUCENA CORRAL SOTELO PCA (PROFESSIONAL COUNSELING ASSOCIATE)
(503) 310-6276
Entity
Organization
Contact information
Practice address
2232 NW EVERETT ST APT 21, PORTLAND, OR 97210-5516
(503) 310-6276
Mailing address
2232 NW EVERETT ST APT 21, PORTLAND, OR 97210-5516
(503) 310-6276
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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