Most Relevant Information
Provider Data
| NPI Number: | 1003687252 |
| Provider Name: | REBECCA SOUPIR LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 11387 |
Most Important Dates
| Enumeration Date: | 01/15/2024 |
| Last Updated: | 01/15/2024 |
Provider Practice Location
1612 5TH ST
LA GRANDE
OR
978502516
Practice Location Phone/Fax
| Phone: | 5419754488 |
| Fax: |
Provider Mailing Location
2206 1ST ST
LA GRANDE
OR
978501705
Provider Mailing Phone/Fax
| Phone: | 5419754488 |
| Fax: |