Individual
EMILEE GRACE HERINCKX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
Mailing address
16492 NW GRAF ST, PORTLAND, OR 97229-7951
(208) 841-5889
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R6905
OR
101YP2500X
Professional Counselor
Primary
C7562
OR
106H00000X
Marriage & Family Therapist
R6905
OR
Other
Enumeration date
05/26/2021
Last updated
09/09/2024
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