Individual
RAFAEL REYNOSO HINOJOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
565 UNION ST NE STE 207, SALEM, OR 97301-2418
(503) 630-3078
Mailing address
3628 MEADOW PARK LOOP NE, SALEM, OR 97305-1585
(503) 630-3078
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
OR
1041C0700X
Clinical Social Worker
Primary
L7699
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500757435
—
OR
Enumeration date
10/05/2018
Last updated
10/01/2020
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