Organization
EMPOWERED FULFILLMENT THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR KRAVITZ (OWNER & CLINICIAN)
(678) 477-8841
Entity
Organization
Contact information
Practice address
110 S BANCROFT ST, PORTLAND, OR 97239-8523
(678) 477-8841
Mailing address
110 S BANCROFT ST, PORTLAND, OR 97239-8523
(678) 477-8841
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2022
Last updated
06/18/2022
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