Individual
AUDRIANA PETRA GARCILAZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
256 E HURLBURT AVE STE 115, HERMISTON, OR 97838-2443
(541) 862-4570
(360) 844-5184
Mailing address
142 EL MONTE ST, UMATILLA, OR 97882-9644
(541) 862-4570
(360) 844-5184
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5495
OR
Other
Enumeration date
05/25/2016
Last updated
01/01/2025
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