Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C1477 | OR |
NPI | 1003019605 |
---|---|
Provider Name | Ms. Hannelore Na Ondrusek |
First Address | Corvallis, OR 97330-6415 |
Second Address | Corvallis, OR 97330-6415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2007 |
Last Update Date | 08/07/2007 |