Individual
KAITLYN WILLCUTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
420 NE 5TH ST, MCMINNVILLE, OR 97128-4603
(408) 334-8901
Mailing address
420 NE 5TH ST, MCMINNVILLE, OR 97128-4603
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/15/2022
Last updated
01/30/2024
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