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General NPI Number Information
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NPI Number | 1962926857
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Entity Type | Organization
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Legal Business Name | UNIQUE PAGE COUNSELING
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 12511 SW 68TH AVE STE 100
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City | PORTLAND
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State | OR
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Zip | 97223-8298
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Country | US
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Telephone | 562-400-8935
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Fax | 562-400-8935
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Provider Business Mailing Address
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Address Line | 11950 SW LINCOLN AVE APT 14
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City | TIGARD
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State | OR
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Zip | 97223-6359
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Country | US
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Telephone | 562-400-8935
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MRS. UNIQUE LAYSHAUN PAGE
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Credential | LPC
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Telephone | 562-400-8935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | C4395
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License Number State | OR
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