Organization
GREAT SOUL COUNSELING&CONSULTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIA MUELLER LPC (THERAPIST)
(503) 449-7955
Entity
Organization
Contact information
Practice address
1235 SE DIVISION ST STE 106C, PORTLAND, OR 97202-1042
(503) 449-7955
Mailing address
1235 SE DIVISION ST STE 106C, PORTLAND, OR 97202-1042
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C2158
OR
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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