Individual
PEGGY DEFAZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
753 NW BROOK ST, NEWPORT, OR 97365-3435
(541) 265-0884
Mailing address
1638 N COAST HWY, NEWPORT, OR 97365-2357
(541) 819-2121
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C3495
OR
Other
Enumeration date
06/17/2014
Last updated
07/21/2020
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