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Individual

JAQULYN L TASKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
(541) 766-6186
Mailing address
PO BOX 579, CORVALLIS, OR 97339-0579
(541) 766-6835
(541) 766-6186

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1632
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C1632
LICENSED PROF. COUNSELOR
OR
Enumeration date
12/04/2006
Last updated
07/08/2007
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