Organization
EMPOWERMENT & TRANSFORMATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANN FAHLSTROM LMFT (PRESIDENT)
(503) 409-5086
Entity
Organization
Contact information
Practice address
189 LIBERTY ST NE, SUITE 202, SALEM, OR 97301-3682
(503) 409-5086
Mailing address
PO BOX 2893, SALEM, OR 97308-2893
(503) 409-5086
(503) 967-6980
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0724
OR
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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