Basic Information
| Provider Information | |||||||||
| NPI: | 1386701985 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELANEY | ||||||||
| FirstName: | MARA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, QMHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 910 OLNEY ST SE | ||||||||
| Address2: | |||||||||
| City: | AUMSVILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973258919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034481054 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3180 CENTER ST NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973014532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035885357 | ||||||||
| FaxNumber: | 5035885400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.