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Individual

MISS CHARLEE SUE MATTINGLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
B.A, QMHP

Contact information

Practice address
805 LIBERTY ST NE STE 2, SALEM, OR 97301-2463
(503) 589-3112
Mailing address
805 LIBERTY ST NE STE 2, SALEM, OR 97301-2463
(503) 589-3112

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/22/2022
Last updated
03/25/2022
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