Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C1588 | OR |
NPI | 1003051350 |
---|---|
Provider Name | Susie Margaret Alin |
First Address | Mcminnville, OR 97128 |
Second Address | Mcminnville, OR 97128-4508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 15/12/2008 |