Organization
MIND BODY THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LYMAN LCSW (EXECUTIVE DIRECTOR)
(503) 567-2225
Entity
Organization
Contact information
Practice address
2857 SE PINE ST, PORTLAND, OR 97214-1837
(503) 567-2225
Mailing address
2857 SE PINE ST, PORTLAND, OR 97214-1837
(503) 567-2225
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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