Individual
MS. CONNIE LAVERNE MCMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LPC NCC
Contact information
Practice address
10260 SW GREENBURG RD, 473, PORTLAND, OR 97223-5500
(503) 544-8221
(503) 246-4446
Mailing address
8193 SW 82ND PL, PORTLAND, OR 97223-6995
(503) 244-6616
(503) 246-4446
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
55781
—
101YP2500X
Professional Counselor
Primary
C1724
OR
Other
Enumeration date
05/22/2007
Last updated
06/02/2016
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