Individual
ADELINE HOLTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC
Contact information
Practice address
45 NW GREELEY AVE, BEND, OR 97703-2943
(541) 800-0443
Mailing address
45 NW GREELEY AVE, BEND, OR 97703-2943
(541) 800-0443
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0000781
CO
1041C0700X
Clinical Social Worker
1093
CO
1041C0700X
Clinical Social Worker
Primary
L7898
OR
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/07/2015
Last updated
07/02/2020
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