Organization
MUSTANG MAGIC EQUINE THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE PELLETIER LCSW (OWNER/CLINICIAN)
(541) 204-1079
Entity
Organization
Contact information
Practice address
62239 POWELL BUTTE HWY, BEND, OR 97701-9355
(541) 204-1079
Mailing address
62239 POWELL BUTTE HWY, BEND, OR 97701-9355
(541) 204-1079
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
09/11/2024
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