Individual provider · Type 1 NPI

Angeline Dominique Willis

Mental Health Counselor · Salem, OR

NPI number 1013477462 Active

Practice location

821 Saginaw St S
Salem, OR 97302-4121

Mailing address

30323 S Bruce Tomlin St
Molalla, OR 97038-7624

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1013477462

Angeline Dominique Willis's National Provider Identifier is 1013477462, issued on Mar 21, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Salem, OR. The record was last updated on Mar 21, 2019.