Individual
DOMINIQUE RACHEL CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 PORTLAND ST, EUGENE, OR 97405-3153
(541) 515-6321
(541) 515-6195
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
(541) 858-8167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
175T00000X
Peer Specialist
THW112506
OR
Other
Enumeration date
12/09/2024
Last updated
01/17/2025
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