Individual
ANNIE WOODWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED ASSOCIATE
Contact information
Practice address
4400 SALEM DALLAS HWY NW, SALEM, OR 97304-3338
(503) 991-5091
Mailing address
4400 SALEM DALLAS HWY NW, SALEM, OR 97304-3338
(503) 991-5091
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
R9123
OR
106S00000X
Behavior Technician
ABA-IN-10182971
OR
Other
Enumeration date
01/05/2018
Last updated
12/04/2024
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