Provider Demographics
NPI:1669744058
Name:HOWELL, MAXINE MARIE ROXANNA (PSS)
Entity type:Individual
Prefix:
First Name:MAXINE
Middle Name:MARIE ROXANNA
Last Name:HOWELL
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 LOCKWOOD RD # 4
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-9733
Mailing Address - Country:US
Mailing Address - Phone:541-643-8173
Mailing Address - Fax:
Practice Address - Street 1:647 W LUELLEN DR STE 3
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2661
Practice Address - Country:US
Practice Address - Phone:541-214-0447
Practice Address - Fax:541-440-9665
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)