Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003045923 |
---|---|
Provider Name | Karissa Lynn Catalano |
First Address | Portland, OR 97231-2798 |
Second Address | Portland, OR 97206-1600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2009 |
Last Update Date | 10/03/2011 |