Individual
MELINDA DEL RIO QUINONES-MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADC III, QMHP
Contact information
Practice address
7215 SE HARNEY ST, PORTLAND, OR 97206-8645
(503) 839-0733
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24-04-30104
OR
101YM0800X
Mental Health Counselor
23-QMHPC-001235
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L11390
OR
Other
Enumeration date
05/03/2017
Last updated
05/01/2024
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