Individual
MS. THERESA CARMODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
12555 SW 1ST ST, BEAVERTON, OR 97005-0546
(503) 382-7843
Mailing address
4206 SW ALFRED ST, PORTLAND, OR 97219-6925
(503) 382-7843
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0688
OR
Other
Enumeration date
05/03/2010
Last updated
04/04/2011
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