Individual
MRS. MARY BETH ENNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
7927 SE ORIENT DRIVE, GRESHAM, OR 97080-8847
(503) 663-0332
(503) 663-1114
Mailing address
7927 SE ORIENT DRIVE, GRESHAM, OR 97080-8847
(503) 663-0332
(503) 663-1114
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1041837
OR
Other
Enumeration date
08/17/2007
Last updated
08/17/2007
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