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Individual

MS. TAYLOR NICOLLE WITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
182 SW ACADEMY ST, DALLAS, OR 97338-1996
(863) 534-6000
Mailing address
927 NW OAK AVE, CORVALLIS, OR 97330-1520
(503) 893-0369

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
12/31/2019
Last updated
11/15/2024
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