Individual
BLISS WENKER BOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
272 NW MEDICAL LOOP STE E, ROSEBURG, OR 97471-5545
(541) 900-4285
Mailing address
425 FRIENDSHIP ST, ASHLAND, OR 97520-3020
(916) 799-5659
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C8389
OR
Other
Enumeration date
08/23/2021
Last updated
10/16/2024
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