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Individual

DAVID LESLIE VANDIEST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A., LPC

Contact information

Practice address
501 NE HOOD AVE STE 240, GRESHAM, OR 97030-7347
(971) 276-5675
Mailing address
501 NE HOOD AVE STE 240, GRESHAM, OR 97030-7347
(971) 276-5675

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6924
OR

Other

Enumeration date
08/05/2022
Last updated
08/05/2022
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