Individual
MS. CORINE BAKAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
967 PARK AVE NE, SALEM, OR 97301-2839
(503) 583-2117
(888) 375-4308
Mailing address
967 PARK AVE NE, SALEM, OR 97301-2839
(843) 495-6500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5501
SC
101YP2500X
Professional Counselor
Primary
C6632
OR
Other
Enumeration date
06/03/2014
Last updated
06/27/2024
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