Individual
MICHELLE C BRANDSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CADC III,MAC
Contact information
Practice address
2051 NE ELK ST, PRINEVILLE, OR 97754-8381
(225) 699-8343
Mailing address
2051 NE ELK ST, PRINEVILLE, OR 97754-8381
(225) 699-8343
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-09-24
OR
101YM0800X
Mental Health Counselor
22-QMHPC-001132
OR
Other
Enumeration date
06/17/2016
Last updated
01/12/2023
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