Individual
JENNIFER LYN KUBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 CENTENNIAL BLVD, SPRINGFIELD, OR 97477-3363
(541) 762-4534
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 684-4100
(541) 684-4165
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497183347
—
OR
Enumeration date
10/30/2013
Last updated
04/25/2019
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