Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 1041C0700X | Clinical Social Worker | ||
N | 225XM0800X | Mental Health |
NPI | 1699228155 |
---|---|
Provider Name | Leticia Ochoa |
First Address | Portland, OR 97204-1810 |
Second Address | Portland, OR 97204-1810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2016 |
Last Update Date | 25/09/2017 |