Individual
EILEEN JEWELL FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, NCC
Contact information
Practice address
339 SW CENTURY DR STE 201, BEND, OR 97702
(541) 508-9354
Mailing address
3616 SW REINDEER AVE, REDMOND, OR 97756-7953
(541) 508-9354
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4069
OR
Other
Enumeration date
04/04/2013
Last updated
08/15/2019
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