Individual
EMILY CATHERINE PERSICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC
Contact information
Practice address
11456 NE KNOTT ST, PORTLAND, OR 97220-1706
(503) 736-6671
Mailing address
15330 SE YAMHILL ST, PORTLAND, OR 97233-2953
(503) 200-7346
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6219
OR
101YM0800X
Mental Health Counselor
R3493
OR
Other
Enumeration date
09/10/2012
Last updated
05/02/2022
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