Individual
MS. LAUREL LEE VANBEUZEKOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1299 NW ELLAN ST STE 3, ROSEBURG, OR 97470-2031
(541) 580-7893
(541) 957-0191
Mailing address
3167 W LORRAINE AVE, ROSEBURG, OR 97471-2439
(541) 580-7893
(541) 957-0191
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0440
OR
207Q00000X
Family Medicine Physician
T0440
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165772
—
OR
05
—
500688893
—
OR
Enumeration date
12/06/2006
Last updated
06/23/2016
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