Individual
AMANDA N LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSWA
Contact information
Practice address
3085 RIVER RD N, SALEM, OR 97303-6512
(541) 321-2278
Mailing address
1075 WASHINGTON ST, EUGENE, OR 97401-4606
(541) 321-2278
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A15381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500768591
—
OR
Enumeration date
08/06/2019
Last updated
08/16/2024
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