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General NPI Number Information
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NPI Number | 1295328821
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Entity Type | Organization
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Legal Business Name | REVOLUTION COUNSELING, LLC
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Dates
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Enumeration Date | 02/15/2021
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 1915 NE STUCKI AVE STE 308
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City | HILLSBORO
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State | OR
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Zip | 97006-6951
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Country | US
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Telephone | 541-286-5207
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Fax |
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Provider Business Mailing Address
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Address Line | 2373 NW 185TH AVE # 635
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City | HILLSBORO
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State | OR
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Zip | 97124-7076
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER MANAGER
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Name | DR. ANJABEEN ASHRAF
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Credential | PHD
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Telephone | 541-286-5207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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