Individual
JILL ANNE GODICI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
422 SE 79TH AVE STE 204, PORTLAND, OR 97215-1519
(503) 473-9880
Mailing address
422 SE 79TH AVE STE 204, PORTLAND, OR 97215-1519
(503) 473-9880
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
L3571
OR
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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