MIKE C THEODORE

BEAVERTON, OR
NPI1316644735
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY  35007)
Enumeration Date2023-02-15
Last Update Date2023-02-15
Business Address
MIKE C THEODORE QMHA
17933 NW EVERGREEN PKWY STE 111
BEAVERTON, OR 97006-7452
Phone number: 814-243-0414
Mailing Address
MIKE C THEODORE QMHA
3159 CARPENTERS PARK RD
DAVIDSVILLE, PA 15928-9223
Phone number: 814-243-0414
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