Individual
MARIE MELLBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CRC, LPC
Contact information
Practice address
7415 N OATMAN AVE, PORTLAND, OR 97217
(503) 789-5092
(503) 289-0943
Mailing address
7415 N OATMAN AVE., PORTLAND, OR 97217-1213
(503) 789-5092
(503) 289-0943
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4927
OR
Other
Enumeration date
10/12/2015
Last updated
08/15/2018
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