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General NPI Number Information
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NPI Number | 1306740949
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Entity Type | Organization
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Legal Business Name | VA
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 8495 CRATER LAKE HWY
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City | WHITE CITY
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State | OR
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Zip | 97503-3011
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Country | US
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Telephone | 541-826-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 587 TEAKWOOD DR
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City | EAGLE POINT
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State | OR
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Zip | 97524-9494
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Country | US
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Telephone | 541-778-0526
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Fax |
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Authorized Official
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Title or Position | VOCATIONAL REHAB. COUNSELOR
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Name | MAHABBAT SNELL
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Credential | LPMHC
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Telephone | 541-826-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State | NULL
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