Individual
MARY C CARLYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 277-1344
Mailing address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 277-1344
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1168
OR
Other
Enumeration date
08/15/2006
Last updated
12/28/2021
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