Individual
MS. LOLA MADRONE BROOMBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
541 WILLAMETTE ST STE 207A, EUGENE, OR 97401-2623
(541) 686-8119
(541) 686-3340
Mailing address
541 WILLAMETTE ST STE 102, EUGENE, OR 97401-2687
(541) 341-3477
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C3168
OR
101YM0800X
Mental Health Counselor
C3168
OR
101YP2500X
Professional Counselor
Primary
C3168
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500692264
—
OR
Enumeration date
07/18/2013
Last updated
04/24/2019
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