Organization
DEEP RIVER COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH L. ANDERSON MA, LPC, ATR (OWNER/MANAGER)
(541) 217-0890
Entity
Organization
Contact information
Practice address
375 PARK AVE STE B, COOS BAY, OR 97420-2244
(541) 217-0890
(541) 266-8408
Mailing address
PO BOX 1478, COOS BAY, OR 97420-0331
(541) 217-0890
(541) 266-8408
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C2373
OR
Other
Enumeration date
06/26/2015
Last updated
07/11/2015
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