Individual
REBECCA D ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CADC III
Contact information
Practice address
1215 MAIN STREET, PHILOMATH, OR 97370
(503) 871-9530
Mailing address
PO BOX 2113, CORVALLIS, OR 97339
(503) 871-9530
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C2239
OR
101YM0800X
Mental Health Counselor
C2239
OR
Other
Enumeration date
06/04/2007
Last updated
08/04/2011
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