Individual
LESLIE O'DONOGHUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHCA, LPC INTERN
Contact information
Practice address
513 E A ST, RAINIER, OR 97048-3124
(503) 432-5053
Mailing address
1105D 15TH AVE # 477, LONGVIEW, WA 98632-3080
(360) 560-0615
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MC61086371
WA
Other
Enumeration date
12/23/2020
Last updated
12/23/2020
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