Doctor Name: | STEPHEN MUSCHETTO |
NPI Number: | 1043544554 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 7126107 |
Business Practice Address: | 420 Ne 5th St Mcminnville, OR - 971284603 |
Business Phone Number: | 5034347462 |
Business Fax Number: | |
Mailing Address: | 420 Ne 5th St, MCMINNVILLE |
State: | OR |
Postal Code: | 971284603 |
Phone Number: | 5034347462 |
Fax Number: | |
NPI Enumeration Date: | 09/30/2009 |
NPI Last Update Date: | 09/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 7126107 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |