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Organization

BEAN BAG THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA PEACOCK MCLAUGHLIN LMFT (SOLE PROPRIETOR/ONLY MEMBER)
(818) 579-2029
Entity
Organization

Contact information

Practice address
25 6TH ST, FAIRVIEW, OR 97024-1941
(818) 579-2029
Mailing address
25 6TH ST, FAIRVIEW, OR 97024-1941
(818) 579-2029

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/28/2021
Last updated
09/28/2021
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