Individual
DANA S DEDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
100 39TH ST # 2B, ASTORIA, OR 97103-2499
(503) 325-2398
(503) 325-5932
Mailing address
100 39TH ST # 2B, ASTORIA, OR 97103-2499
(503) 325-2398
(503) 325-5932
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C1489
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710172802
AGENCY NPI
OR
Enumeration date
08/19/2011
Last updated
08/19/2011
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