Lawrence Squiemphen, CADC I
Counselor, Addiction (Substance Use Disorder) in Madras, OR. Individual provider (NPI-1).
NPI number1669948857
StatusActive
Last updated in NPPESMar 13, 2019
Details
- NPI
- 1669948857
- Entity type
- Individual (NPI-1)
- Name
- Mr. Lawrence Squiemphen
- Credential
- CADC I
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 16, 2018
- Last updated
- Mar 13, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | T-17-163 | OR | Yes |
Practice location
125 Sw C StMadras, OR 97741-1458
Phone 541-306-4566 · Fax 541-320-9005
Mailing address
1435 Ne 4th St Ste BBend, OR 97701-4268
Phone 541-306-4446 · Fax 541-550-2011
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