Individual
MRS. LORI L GUIDICATTIEVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC 1
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(844) 494-5105
Mailing address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(844) 494-5105
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21-01-10031
OR
Other
Enumeration date
03/31/2021
Last updated
03/31/2021
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