Individual
DALE WILLIAM EVOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1233 EDGEWATER ST NW STE B, SALEM, OR 97304-4049
(503) 378-7526
Mailing address
1233 EDGEWATER ST NW STE B, SALEM, OR 97304-4049
(503) 378-7526
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LMFT48473
CA
101YM0800X
Mental Health Counselor
Primary
T2549
OR
106H00000X
Marriage & Family Therapist
LMFT48473
CA
106H00000X
Marriage & Family Therapist
T0799
OR
Other
Enumeration date
01/30/2012
Last updated
08/21/2024
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