Organization
LEAF & LOAM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN S MARVIN LCSW (PRACTICE MANAGER)
(630) 887-6675
Entity
Organization
Contact information
Practice address
2329 NE RODNEY AVE, PORTLAND, OR 97212-3703
(630) 887-6675
(503) 961-7266
Mailing address
2329 NE RODNEY AVE, PORTLAND, OR 97212-3703
(630) 887-6675
(503) 961-7266
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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