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Individual

PAUL L ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRM

Contact information

Practice address
23 NW GREENWOOD AVE, BEND, OR 97703-2078
(541) 383-4293
(541) 383-4935
Mailing address
23 NW GREENWOOD AVE, BEND, OR 97703-2078
(541) 383-4293
(541) 383-4935

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-03-10354
OR
175T00000X
Peer Specialist
19-CRM-301
OR

Other

Enumeration date
01/07/2020
Last updated
04/04/2022
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