Individual
COURTNEY BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2222 COBURG RD, EUGENE, OR 97401-4966
(458) 210-2984
(458) 210-2985
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
01/06/2020
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