MIKENNA RAE CARPENTER
Individual Provider (NPI-1)
Active
Social Worker, Clinical
Provider Information
- NPI Number
1457223109- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1800 BLANKENSHIP RD STE 448, WEST LINN, OR, 970684191
- Phone
- (971) 378-0367
- Fax
- (503) 974-9679
Specialties & Taxonomies
Social Worker, Clinical
Primary License: OR #A17079