Individual
MIKKI PROFFITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCI
Contact information
Practice address
19595 SE MARTIN RD, SANDY, OR 97055-8241
(541) 306-1254
Mailing address
PO BOX 1825, ESTACADA, OR 97023-1825
(541) 306-1254
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CADCI
OR
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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