person
Mr. Larston Petticord, MS,LPC
Mental Health Counselor in Portland, Oregon
NPI 1871889261

Larston Petticord is a Mental Health Counselor based in Portland, OR and is specialized in Mental Health. Larston Petticord practices in Portland, OR and has the professional credentials of MS,LPC. The NPI Number for Larston Petticord is 1871889261 and holds a License No. (Oregon).

The current practice location address for Larston Petticord is 3419 Ne Sandy Blvd, Portland, OR and can be reached out via phone at 503-914-6199.

Location: 3419 Ne Sandy Blvd, Portland, OR, 97220-2362
person
Provider Profile Details
NPI Number
1871889261
Provider Name
Larston Petticord
Credential
MS,LPC
Provider Entity Type
Individual
Gender
Male
Address
3419 Ne Sandy Blvd, Portland, OR, 97220-2362
Phone Number
503-914-6199
Fax Number
Provider Enumeration Date
06/23/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3419 Ne Sandy Blvd
City
State
Zip
97232-1959
Phone Number
503-914-6199
Fax Number
person
Provider Business Mailing Address Details
Address
3419 Ne Sandy Blvd
City
State
Zip
97232-1959
Phone Number
503-914-6199
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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