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Individual

THERESE N MASTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., QMHP

Contact information

Practice address
1345 BIRCH AVE, COTTAGE GROVE, OR 97424-1416
(541) 942-3939
(541) 942-9310
Mailing address
410 N 9TH ST, PO BOX 5, COTTAGE GROVE, OR 97424-1307
(541) 942-2850
(541) 942-1574

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
Primary
C8458
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019047
OR
Enumeration date
04/17/2009
Last updated
06/10/2026
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