Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 16-R-38 | OR |
NPI | 1013011469 |
---|---|
Provider Name | Mrs. Charlotte Marie Rector |
First Address | Beaverton, OR 97007-8244 |
Second Address | Beaverton, OR 97005-3306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 24/01/2018 |