Organization
INNER WELLNESS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ELIZABETH MENGEDOHT MSW LCSW (CLINICAL SOCIAL WORKER)
(503) 468-8646
Entity
Organization
Contact information
Practice address
100 39TH ST STE 203, ASTORIA, OR 97103-2455
(503) 468-8646
(503) 325-2813
Mailing address
100 39TH ST STE 203, ASTORIA, OR 97103-2455
(503) 468-8646
(503) 325-2813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6223
OR
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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