Individual
ALICIA SIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., MFT ASSOCIATE
Contact information
Practice address
510 SW 3RD AVE STE 200, PORTLAND, OR 97204-2507
(503) 512-0958
Mailing address
6312 SW CAPITOL HWY # 245, PORTLAND, OR 97239-1938
(503) 512-0958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R5094
OR
Other
Enumeration date
10/06/2021
Last updated
10/06/2021
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