DIRK WILLIAM STAFFORD

PHOENIX, OR
NPI1558905000
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2019-10-28
Last Update Date2019-10-28
Business Address
DIRK WILLIAM STAFFORD
149 S MAIN ST
PHOENIX, OR 97535-6631
Phone number: 541-535-4133
Mailing Address
DIRK WILLIAM STAFFORD
220 SWEETBRIAR DR
TALENT, OR 97540-8617
Phone number: 541-690-9693