Individual
MARY MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCII
Contact information
Practice address
16420 SE DIVISION ST, PORTLAND, OR 97236-1987
(503) 762-3130
(503) 762-3199
Mailing address
2500 MAITLAND CENTER PKWY STE 250, MAITLAND, FL 32751-4174
(407) 351-7080
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
89-01-08
OR
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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