Individual
LAURIE J WITTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Mailing address
3425 13TH ST, BAKER CITY, OR 97814-1340
(541) 523-7400
(541) 523-4927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
19-QMHPC-00903
OR
101YP2500X
Professional Counselor
Primary
C7897
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4559332
ODL
OR
05
—
500699838
—
OR
Enumeration date
09/28/2015
Last updated
01/16/2024
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