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Individual

PAULINE ANNE PICCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2100 SE BELMONT ST, PORTLAND, OR 97214-2815
(503) 674-7777
Mailing address
2401 SE 121ST AVE, PORTLAND, OR 97216-4040
(503) 761-2744

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
L3133
OR

Other

Enumeration date
04/02/2007
Last updated
12/13/2011
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