Individual
CHARLENE DELOISE MCCLEOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 238-0769
Mailing address
PO BOX 14614, PORTLAND, OR 97293-0614
(971) 393-6084
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10510
OR
Other
Enumeration date
01/28/2013
Last updated
12/19/2022
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