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Individual

MELVA JEANNETTE PENNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC, NCC, CGACII

Contact information

Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 947-4240
Mailing address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 947-4240

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
G 08-04-06
OR
101YM0800X
Mental Health Counselor
NCC-201117
101YP2500X
Professional Counselor
C1987
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100113
AMISYS ID
AZ
05
970758
AZ
Enumeration date
09/08/2006
Last updated
03/15/2011
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