Individual
MRS. SUSAN J WILSON MAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCII
Contact information
Practice address
32274 SCAP-VERM HWY, SCAPPOOSE, OR 97056-2317
(503) 987-1439
Mailing address
32274 SCAP-VERN HWY, SCAPPOOSE, OR 97056-2317
(503) 987-1439
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-07-43
OR
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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