Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103K00000X | Behavior Analyst | B-10197672 | OR |
NPI | 1003275579 |
---|---|
Provider Name | Lindsey Pieschel |
First Address | Portland, OR 97223-6876 |
Second Address | Portland, OR 97223-6876 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2016 |
Last Update Date | 30/09/2021 |