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Individual

TERESA SUZANNE BRISBIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA MFT

Contact information

Practice address
18650 SW BOONES FERRY RD, SUITE 3, TUALATIN, OR 97062-8491
(502) 476-2934
Mailing address
720 SE 9TH ST, DUNDEE, OR 97115-9635
(503) 476-2934

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
R2697
OR
106H00000X
Marriage & Family Therapist
Primary
R2698
OR

Other

Enumeration date
10/17/2012
Last updated
10/17/2012
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