Individual
MRS. GLORIA LYNNE HENRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2400 LANCASTER DR NE, SALEM, OR 97305-1221
(503) 361-5400
Mailing address
2240 NW CLUSTER OAK AVE, ALBANY, OR 97321-1064
(541) 926-2910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T0447
OR
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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