Organization
DEEPER WELL PSYCHOTHERAPY AND COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA P ORR MA, LMFT (OWNER)
(831) 331-5993
Entity
Organization
Contact information
Practice address
120 SW 4TH ST, CORVALLIS, OR 97333-4724
(541) 262-0080
Mailing address
3316 SE HATHAWAY DR, CORVALLIS, OR 97333-9262
(831) 331-5993
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497192306
—
OR
Enumeration date
08/02/2018
Last updated
04/10/2023
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