Organization
CHARLES R OBANNON
Active
Other names
RENAISSANCE COUNSELING LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES RICHARD O'BANNON PH.D. (LICENSED PSYCHOLOGIST / OWNER)
(503) 618-8041
Entity
Organization
Contact information
Practice address
31090 SE DIVISION DR, TROUTDALE, OR 97060-9451
(503) 618-8041
(503) 618-8052
Mailing address
31090 SE DIVISION DR, TROUTDALE, OR 97060-9451
(503) 618-8041
(503) 618-8052
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
07/23/2014
Last updated
09/25/2015
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