Provider Demographics
NPI:1609085661
Name:GUILLAUME, NAHOMIE MOISE (MASTERS DEGREE/LMFT)
Entity Type:Individual
Prefix:
First Name:NAHOMIE
Middle Name:MOISE
Last Name:GUILLAUME
Suffix:
Gender:F
Credentials:MASTERS DEGREE/LMFT
Other - Prefix:
Other - First Name:NAHOMIE
Other - Middle Name:
Other - Last Name:MOISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:20333 STATE HIGHWAY 249 STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2613
Mailing Address - Country:US
Mailing Address - Phone:503-922-3360
Mailing Address - Fax:971-352-4229
Practice Address - Street 1:1110 SE ALDER ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:503-922-3360
Practice Address - Fax:971-352-4229
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1492106H00000X
TX202775106H00000X
CAMFT48571106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist