Individual
JESSICA KATHLEEN HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1184 3RD ST STE C, LAFAYETTE, OR 97127-9660
(503) 764-5377
Mailing address
1184 3RD ST STE C, LAFAYETTE, OR 97127-9660
(503) 764-5377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
C-703
OR
Other
Enumeration date
11/10/2010
Last updated
10/11/2024
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