Individual
MAUREEN ANITA DE LEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHPR
Contact information
Practice address
833 ANDERSON AVE STE 6, COOS BAY, OR 97420-4641
(541) 286-6238
Mailing address
1609 N 10TH ST, COOS BAY, OR 97420-2644
(541) 808-3597
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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