Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C2612 | OR |
N | 101YS0200X | School Counselor | 810272 | OR |
NPI | 1205112125 |
---|---|
Provider Name | Linda Faye Poole |
First Address | Oregon City, OR 97045-8182 |
Second Address | Oregon City, OR 97045-8182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2011 |
Last Update Date | 13/06/2014 |