Individual
LAKOTAKA DAWN JASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC CANDIDATE
Contact information
Practice address
350 E 11TH AVE, EUGENE, OR 97401-3246
(541) 683-1641
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 684-4156
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
101YM0800X
Mental Health Counselor
24-QMHA-R-5475
OR
Other
Enumeration date
08/27/2018
Last updated
07/08/2024
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