Individual
MS. MARY B. WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2965 NE CONNERS AVE STE 280, BEND, OR 97701-7753
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6210, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4719
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500685125
—
OR
Enumeration date
07/06/2011
Last updated
03/17/2018
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