Provider Demographics
NPI:1942407259
Name:CARRILLO, ALISON BRANDI (MSW)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BRANDI
Last Name:CARRILLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757 NW CANYON DR
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1116
Mailing Address - Country:US
Mailing Address - Phone:541-318-4845
Mailing Address - Fax:541-318-5156
Practice Address - Street 1:63360 BRITTA ST BUILDING 1
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701
Practice Address - Country:US
Practice Address - Phone:541-318-4845
Practice Address - Fax:541-318-5156
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical