Individual
RAPHEL DANIELLE COUSINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8536 SE STARK ST, PORTLAND, OR 97216-1140
(541) 944-3688
Mailing address
9110 NW WOOD ROSE LOOP, PORTLAND, OR 97229-4190
(541) 944-3688
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L8263
OR
Other
Enumeration date
01/21/2020
Last updated
01/21/2020
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