Individual provider · Type 1 NPI

Athena Leeann Wildenborg, T-23-2498

Counselor · Roseville, CA

NPI number 1326812488 Active

Practice location

200 La Loma Ct
Roseville, CA 95678-2908

Call (360) 214-4102 Map

Mailing address

1122 NE 122nd Ave Ste A102
Portland, OR 97230-2082

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XT-23-2498 (OR)

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1326812488

Athena Leeann Wildenborg, T-23-2498's National Provider Identifier is 1326812488, issued on Nov 9, 2023. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Roseville, CA. The record was last updated on Nov 9, 2023.