Individual
CARL CASANOVA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,
Contact information
Practice address
11650 SW 67TH AVE STE 230, PORTLAND, OR 97223-8590
(503) 422-1143
Mailing address
11650 SW 67TH AVE STE 230, TIGARD, OR 97223-8590
(503) 422-1143
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OR
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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