Organization
JODI LIETZ COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JODI MARIE LIETZ MS, LMFT INTERN (COUNSELOR)
(360) 608-1010
Entity
Organization
Contact information
Practice address
1020 SW TAYLOR ST, SUITE 557, PORTLAND, OR 97205-2543
(503) 710-9099
Mailing address
1500 SW 11TH AVE, UNIT 2701, PORTLAND, OR 97201-3532
(360) 608-1010
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
R3860
OR
Other
Enumeration date
09/18/2015
Last updated
09/18/2015
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