Individual
DESIREE MIA SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 757-1852
Mailing address
1535 SALMON RUN SW, ALBANY, OR 97321
(541) 967-0254
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
07/05/2007
Last updated
07/08/2007
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