Organization
BEND EMBODIED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AUTUMN STACEY MARLER LPCA (OWNER)
(720) 442-4114
Entity
Organization
Contact information
Practice address
825 SW THEATER DR, BEND, OR 97702-3509
(720) 442-4114
Mailing address
825 SW THEATER DR, BEND, OR 97702-3509
(720) 442-4114
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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