Organization
SPARROW PROFESSIONAL DEVELOPMENT & COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SLAD F THACKERAY (DIRECTOR/OWNER)
(503) 910-6822
Entity
Organization
Contact information
Practice address
607 SE JEFFERSON ST, DALLAS, OR 97338-2025
(503) 910-6822
Mailing address
1151 SW LEVENS ST, DALLAS, OR 97338-2266
(503) 910-6822
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/25/2021
Last updated
11/05/2021
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