Individual
MISS MICHELLE ROSE TERRANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
1312 SW WASHINGTON ST, PORTLAND, OR 97205-2327
(503) 535-1151
Mailing address
1455 DIXON AVE, LAFAYETTE, CO 80026-8879
(303) 443-8500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/15/2015
Last updated
12/09/2019
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