Individual
MRS. KATELYN RUBERT DELANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
930 NW 12TH AVE, APT 216, PORTLAND, OR 97209-3066
(732) 233-7820
Mailing address
930 NW 12TH AVE, APT 216, PORTLAND, OR 97209-3066
(732) 233-7820
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
L4633
OR
1041C0700X
Clinical Social Worker
L4633
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L4633
OREGON BOARD OF LICENSED SOCIAL WORKERS
OR
Enumeration date
02/07/2012
Last updated
02/07/2012
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