Individual
JENNIFER EILEEN CRACKENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADCI
Contact information
Practice address
617 NE DAVIS ST, MCMINNVILLE, OR 97128-4716
(503) 472-4020
Mailing address
617 NE DAVIS ST, MCMINNVILLE, OR 97128-4716
(503) 472-4020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3769
OR
Other
Enumeration date
09/08/2009
Last updated
05/21/2015
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