Individual
MRS. JACQUELYN C LANCOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 854-0157
Mailing address
1160 LIBERTY ST SE, SALEM, OR 97302-4143
(503) 854-0157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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