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General NPI Number Information
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NPI Number | 1467666024
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Entity Type | Organization
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Legal Business Name | TFP THERAPEUTIC SERVICE, INC.
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 390 NE 2ND STREET
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-889-1050
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Fax | 541-889-6524
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Provider Business Mailing Address
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Address Line | PO BOX V
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City | ONTARIO
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State | OR
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Zip | 97914
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Country | US
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Telephone | 541-889-1050
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Fax | 541-889-6524
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TESS DIANE SHELLENBARGER
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Credential | LCPC, LPC, MAC, CADC
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Telephone | 541-889-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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