Individual
VICTORIA E PRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC MAC
Contact information
Practice address
731 NW FRANKLIN AVE, SUITE 107, BEND, OR 97701-2752
(541) 788-0701
Mailing address
20807 DIONE WAY, BEND, OR 97701-8421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1527
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
C1527
OR
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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