Individual
MRS. MARTHA R WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, QMHP
Contact information
Practice address
1675 WINTER ST NE, SALEM, OR 97301-7152
(503) 585-0351
Mailing address
484 JUEDES AVE N, KEIZER, OR 97303-5452
(971) 707-8074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3572
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/07/2007
Last updated
01/18/2022
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