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Individual

KIMBERLY ANN SCHAFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.A., CADCII, QMHA

Contact information

Practice address
4211 W 11TH AVE, EUGENE, OR 97402-5435
(541) 485-1577
Mailing address
4211 W 11TH AVE, EUGENE, OR 97402-5435
(541) 425-1577

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
05-03-61
OR
101YM0800X
Mental Health Counselor
20-QMHA-I-03085
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500660768
OR
Enumeration date
12/02/2008
Last updated
09/23/2024
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