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Individual

PHOENIX RIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,LPC

Contact information

Practice address
1322 MAIN ST., PHILOMATH, OR 97370
(541) 929-5065
Mailing address
PO BOX 1394, PHILOMATH, OR 97370-1394
(541) 929-5065

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1015
OR

Other

Enumeration date
01/18/2007
Last updated
07/08/2007
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