POTENTIALS, LLC
Agencies at 39 St, Tongue Point, OR

License number
Oregon C1489
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: MS. DANA S DEDOLPH MA, LPC
Title: DIRECTOR/THERAPIST
Phone: (503) 325-2398
Address
Address
100 39Th St, Tongue Point, OR 97103
National Provider ID: 1710173802
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about POTENTIALS, LLC at bizstanding.com

POTENTIALS, LLC

Tongue Point, OR

Industry:
Individual/Family Services
Registration:
Sep 16, 2004
Addresses:
100 - 39 St STE 2B PIER 39, Astoria, OR 97103 (Physical)
100 39 St STE 2B PIER 39, Astoria, OR 97103 (Mailing)
PO Box 776, Tongue Point, OR 97103
State ID:
23992191
Business type:
DOMESTIC LIMITED LIABILITY COMPANY
Allied Health Professional, Director, Manager, Psychologist:
Dana D. Dedolph (Allied Health Professional, Director, Manager, Psychologist)
Agent:
Dana Dedolph,100 39 St STE 202B, Astoria, OR 97103 (Physical)

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