Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor |
NPI | 1003026196 |
---|---|
Provider Name | Ms. Diane Boyce |
First Address | North Bend, OR 97459-3482 |
Second Address | North Bend, OR 97459-3482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |