Individual
YESENIA HERNANDEZ AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2637 BOURBON ST, FOREST GROVE, OR 97116-1543
(503) 265-9877
Mailing address
2637 BOURBON ST, FOREST GROVE, OR 97116-1543
(503) 265-9877
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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