Doctor Name: | MR. ALBERT LEROY PACE |
NPI Number: | 1033509476 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 672 Ne Evans St. Mcminnville, OR - 97128 |
Business Phone Number: | 5034347505 |
Business Fax Number: | |
Mailing Address: | 422 N Meridian St, #v288 NEWBERG |
State: | OR |
Postal Code: | 971322699 |
Phone Number: | 3035245578 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2015 |
NPI Last Update Date: | 01/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |