Individual
DR. THOMAS WESLEY AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSED COUNSELOR
Contact information
Practice address
880 MAIN ST, LEBANON, OR 97355
(541) 258-8210
(541) 258-8212
Mailing address
PO BOX 280, LEBANON, OR 97355-0280
(541) 258-8210
(541) 258-8212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
C1962
OR
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227513
NATIONAL BOARD CERTIFIED COUNSELOR
NC
01
—
C1962
LICENSED PROFESSIONAL COUNSELOR
OR
Enumeration date
04/07/2009
Last updated
12/29/2016
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