Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health |
NPI | 1770904203 |
---|---|
Provider Name | Halley Read |
First Address | Mcminnville, OR 97128-3923 |
Second Address | Mcminnville, OR 97128-3923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2013 |
Last Update Date | 31/12/2013 |