Individual
MICHELLE DAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, QMHP
Contact information
Practice address
777 NE 7TH ST STE 208, GRANTS PASS, OR 97526-1632
(503) 884-3946
(503) 200-1302
Mailing address
PO BOX 445, MURPHY, OR 97533-0445
(503) 884-3946
(503) 200-1302
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L5319
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500800774
—
OR
Enumeration date
01/27/2009
Last updated
01/07/2025
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