Individual
MRS. ANGELA LYN KUBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
9911 SE MOUNT SCOTT BLVD, PORTLAND, OR 97266-6302
(503) 233-4356
Mailing address
1200 NW MARSHALL ST STE 608, PORTLAND, OR 97209-3170
(503) 680-0150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/15/2010
Last updated
11/15/2010
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