Individual
BETHANY BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7527
(503) 434-9846
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7527
(503) 434-9846
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12-12-02
OR
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/01/2013
Last updated
09/06/2013
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