Individual
MARY ANN DEARBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Mailing address
906 MAIN AVE, TILLAMOOK, OR 97141-3816
(503) 842-8201
(503) 815-1870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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