Individual
SHELLY RAE OTTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
880 S MAIN ST, LEBANON, OR 97355-3210
(541) 933-5730
Mailing address
30077 INGRAM RD, LEBANON, OR 97355-9506
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C8833
OR
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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