Ann Marie Moylan, LCSW
Social Worker, Clinical in Portland, OR. Individual provider (NPI-1).
NPI number1164099081
StatusActive
Last updated in NPPESJan 7, 2025
Details
- NPI
- 1164099081
- Entity type
- Individual (NPI-1)
- Name
- Ann Marie Moylan
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 9, 2021
- Certification date
- Jan 7, 2025
- Last updated
- Jan 7, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 15431 | OR | Yes |
| 101YM0800X | Counselor, Mental Health | 6126 | NE |
Practice location
1717 Ne 42nd Ave Ste 3100Portland, OR 97213-1572
Phone 503-567-5103
Mailing address
1717 Ne 42nd Ave Ste 3100Portland, OR 97213-1572
Phone 503-567-5103
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