Individual
DUDLEY PIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LPC
Contact information
Practice address
333 S FLOWER ST, PORTLAND, OR 97239-3797
(815) 326-2195
Mailing address
11635 NE PRESCOTT ST, PORTLAND, OR 97220-1434
(815) 326-2195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.009745
IL
101YP2500X
Professional Counselor
Primary
C4494
—
Other
Enumeration date
02/15/2017
Last updated
06/10/2024
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