Individual
PATTI LYNN LEBOUEF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3009 DIAMOND LAKE BLVD, ROSEBURG, OR 97470
(541) 673-3469
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/20/2024
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