Individual
ANYA GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, QMHP
Contact information
Practice address
998 LIBRARY CT, OREGON CITY, OR 97045-4041
(503) 655-8401
Mailing address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 867-3817
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2014
Last updated
02/20/2020
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