Doctor Name: | MRS. MELODY SUE GEORGE |
NPI Number: | 1033409313 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 4820 |
Business Practice Address: | 11895 Sw Greenburg Rd Tigard, OR - 972236450 |
Business Phone Number: | 5035973894 |
Business Fax Number: | 5035973895 |
Mailing Address: | 11895 Sw Greenburg Rd, TIGARD |
State: | OR |
Postal Code: | 972236450 |
Phone Number: | 5035973894 |
Fax Number: | 5035973895 |
NPI Enumeration Date: | 04/07/2011 |
NPI Last Update Date: | 04/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 4820 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |