Individual
DEAN H CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., QMHP
Contact information
Practice address
3180 CENTER ST NE, SALEM, OR 97301-4532
(801) 472-3315
Mailing address
934 ORCHARD ST N, KEIZER, OR 97303-5747
(801) 472-3315
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/28/2007
Last updated
12/28/2007
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