Individual
MAYRA COLIN CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
104 S.W. KINKADE RD., BOARDMAN, OR 97818
(541) 481-2911
(541) 481-2006
Mailing address
PO BOX 469, HEPPNER, OR 97836-0469
(541) 676-9161
(541) 676-5662
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C7959
OR
Other
Enumeration date
07/12/2012
Last updated
10/07/2024
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