Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C4767 | OR |
NPI | 1003380478 |
---|---|
Provider Name | Emily R Hinman |
First Address | Portland, OR 97211-4387 |
Second Address | Portland, OR 97212-5321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2019 |
Last Update Date | 17/01/2019 |