Individual
BENJAMIN A LA MAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW INTERN
Contact information
Practice address
375 PARK AVE STE 2, COOS BAY, OR 97420-2242
(541) 404-6238
Mailing address
63875 WALLACE RD, COOS BAY, OR 97420-8779
(541) 404-6238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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