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Individual

DANIEL BIRT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MMT, MT-BC/L, QMHP

Contact information

Practice address
113 N ELM ST, CANBY, OR 97013-3519
(503) 372-5147
(503) 650-4302
Mailing address
113 N ELM ST, CANBY, OR 97013-3519
(541) 858-8170

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
21-QMHP-R-0771
OR
101YM0800X
Mental Health Counselor
Primary
225A00000X
Music Therapist
10186042
OR

Other

Enumeration date
05/26/2015
Last updated
05/26/2022
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