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1013477462
ANGELINE DOMINIQUE WILLIS
SALEM, OR
NPI
1013477462
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-03-21
Last Update Date
2019-03-21
Business Address
ANGELINE DOMINIQUE WILLIS
821 SAGINAW ST S
SALEM, OR 97302-4121
Phone number: 503-315-8646
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Mailing Address
ANGELINE DOMINIQUE WILLIS
30323 S BRUCE TOMLIN ST
MOLALLA, OR 97038-7624
Phone number: 503-654-3400
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