Individual
ANGELICA LUCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3716 NE MLK JR BLVD, PORTLAND, OR 97212-1111
(503) 746-3290
Mailing address
17376 NE COUCH ST, APT K249, PORTLAND, OR 97230-6462
(503) 746-3290
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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