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Deziree Mya Brock
Counselor in Corvallis, Oregon
NPI 1730797820

Deziree Mya Brock is a Counselor based in Portland, OR. Deziree Mya Brock practices in Corvallis, OR. The NPI Number for Deziree Mya Brock is 1730797820 and holds a License No. (Oregon).

The current practice location address for Deziree Mya Brock is 4455 Ne Highway 20, Corvallis, OR and can be reached out via phone at 541-758-5900.

Location: 4455 Ne Highway 20, Corvallis, OR, 97202-3371
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730797820
Provider Name
Deziree Mya Brock
Credential
Provider Entity Type
Individual
Gender
Female
Address
4455 Ne Highway 20, Corvallis, OR, 97202-3371
Phone Number
541-758-5900
Fax Number
Provider Enumeration Date
07/15/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4455 Ne Highway 20
City
Corvallis
State
Oregon
Zip
97330-9695
Phone Number
541-758-5900
Fax Number
person
Provider Business Mailing Address Details
Address
4455 Ne Highway 20
City
Corvallis
State
Oregon
Zip
97330-9695
Phone Number
541-758-5900
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
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's degree and clinical experience and supervision for licensure or certification.
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