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Individual

MRS. DEVORA LEE RUBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
15 NW PARK PLACE, SUITE 130 CROSSWATERS FAMILY THERAPY, BEND, OR 97703
(541) 610-8391
(541) 726-5085
Mailing address
15 NW PARK PLACE, SUITE 130 CROSSWATERS FAMILY THERAPY, BEND, OR 97703
(541) 610-8391
(541) 726-5085

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2187
OR
1041C0700X
Clinical Social Worker
2187
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164936
OR
01
R0000WDBCH
MEDICARE GROUP
OR
Enumeration date
12/12/2010
Last updated
06/17/2019
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