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Dirk William Stafford
Mental Health Counselor in Phoenix, Oregon
NPI 1558905000

Dirk William Stafford is a Mental Health Counselor based in Talent, OR and is specialized in Mental Health. Dirk William Stafford practices in Phoenix, OR. The NPI Number for Dirk William Stafford is 1558905000 and holds a License No. (Oregon).

The current practice location address for Dirk William Stafford is 149 S Main St, Phoenix, OR and can be reached out via phone at 541-535-4133.

Location: 149 S Main St, Phoenix, OR, 97540-8617
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558905000
Provider Name
Dirk William Stafford
Credential
Provider Entity Type
Individual
Gender
Male
Address
149 S Main St, Phoenix, OR, 97540-8617
Phone Number
541-535-4133
Fax Number
Provider Enumeration Date
10/28/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
149 S Main St
City
Phoenix
State
Oregon
Zip
97535-6631
Phone Number
541-535-4133
Fax Number
person
Provider Business Mailing Address Details
Address
149 S Main St
City
Phoenix
State
Oregon
Zip
97535-6631
Phone Number
541-535-4133
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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