Individual
MISS MISTY THERESA AULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12901 SE 97TH AVE STE 340, CLACKAMAS, OR 97015-7903
(503) 655-6806
Mailing address
12901 SE 97TH AVE STE 340, CLACKAMAS, OR 97015-7903
(503) 655-6806
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/03/2019
Last updated
01/22/2021
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