Individual
MS. THERESA M DESOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII, QHMA-I
Contact information
Practice address
389 SW SCALEHOUSE CT, BEND, OR 97702-3241
(541) 306-4466
Mailing address
389 SW SCALEHOUSE CT, BEND, OR 97702-3241
(541) 306-4446
(541) 550-2011
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-R-26
OR
101YM0800X
Mental Health Counselor
25-QHMA-I005194
OR
Other
Enumeration date
02/26/2009
Last updated
11/13/2025
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