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General NPI Number Information
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NPI Number | 1699218826
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Entity Type | Individual
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Provider Name | ERICA MARIE MAU MS, LPC, NCC, CCTP
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Gender | Female
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Dates
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Enumeration Date | 11/20/2016
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 17400 SE 422ND AVE
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City | SANDY
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State | OR
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Zip | 97055-6729
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Country | US
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Telephone | 503-705-9379
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Fax |
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Provider Business Mailing Address
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Address Line | 17400 SE 422ND AVE
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City | SANDY
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State | OR
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Zip | 97055-6729
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Country | US
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Telephone | 503-705-9379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | C4378
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License Number State | OR
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