Individual
MARET BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, CADC I
Contact information
Practice address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2026
Mailing address
9605 GRAND RONDE RD, GRAND RONDE, OR 97347-9712
(503) 879-2026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21-R-31
OR
101YP2500X
Professional Counselor
Primary
C7229
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000
NONE
MN
Enumeration date
08/10/2021
Last updated
01/11/2024
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