Individual provider · Type 1 NPI

Dirk William Stafford

Mental Health Counselor · Phoenix, OR

NPI number 1558905000 Active

Practice location

149 S Main St
Phoenix, OR 97535-6631

Call (541) 535-4133 Map

Mailing address

220 Sweetbriar Dr
Talent, OR 97540-8617

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1558905000

Dirk William Stafford's National Provider Identifier is 1558905000, issued on Oct 28, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Phoenix, OR. The record was last updated on Oct 28, 2019.