Individual
LISA BURNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1622 MAIN ST, PHILOMATH, OR 97370-9237
(541) 929-5683
Mailing address
1622 MAIN ST, PHILOMATH, OR 97370-9237
(541) 929-5683
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4878
OR
Other
Enumeration date
03/28/2014
Last updated
01/17/2024
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