Individual
MS. AUTUMN STACEY MARLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC ASSOCIATE
Contact information
Practice address
825 SW THEATER DR, BEND, OR 97702-3509
(541) 633-9161
Mailing address
825 SW THEATER DR, BEND, OR 97702-3509
(720) 442-4114
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
R7164
OR
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
10/12/2021
Last updated
06/05/2023
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