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BROOKE ANDERSON MSW, QMHP

Behavioral Health & Social Service Providers Counselor Addiction (Substance Use Disorder)

Provider NPI: 1376725523

Provider Information:
 BROOKE  ANDERSON MSW, QMHP
Gender: F
Not Sole Proprietor

Practice Location:
4212 SE DIVISION ST  PORTLAND, OR 97206-1628 US
Tel: 503-238-0705  Fax: --

Business Mailing Address:
PO BOX 8459  PORTLAND, OR 97207 US
Tel: --  Fax: --

NPI Information:
NPI: 1376725523
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
N101YM0800XBehavioral Health & Social Service Providers
Counselor
N372600000XNursing Service Related Providers
Adult Companion

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 101YA0400X

Type:

Classification:



Definition:



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