Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003143611 |
---|---|
Provider Name | Meghan Thivierge |
First Address | Hillsboro, OR 97123-5651 |
Second Address | Hillsboro, OR 97123-5651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2009 |
Last Update Date | 03/11/2009 |