Doctor Name: | DENISE K MADDOCK |
NPI Number: | 1134287444 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BS, COTA/L |
License Number: | RC00044065 |
Business Practice Address: | 4560 Se International Way Ste 100 Milwaukie, OR - 972224628 |
Business Phone Number: | 9712065467 |
Business Fax Number: | 9712065209 |
Mailing Address: | 4560 Se International Way Ste 100, MILWAUKIE |
State: | OR |
Postal Code: | 972224628 |
Phone Number: | 9712065467 |
Fax Number: | 9712065209 |
NPI Enumeration Date: | 12/05/2006 |
NPI Last Update Date: | 07/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | RC00044065 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |