Individual
AMANDA HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
833 SW 11TH AVE STE 915, PORTLAND, OR 97205-2123
(971) 940-8114
Mailing address
833 SW 11TH AVE STE 915, PORTLAND, OR 97205-2123
(971) 940-8114
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2014
Last updated
12/10/2019
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