Individual
MR. LONNY RAY BEVILL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MFT
Contact information
Practice address
2817 SANTIAM HWY SE, ALBANY, OR 97322-5254
(541) 905-5423
Mailing address
PO BOX 3068, ALBANY, OR 97321-0701
(541) 905-5423
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
27681
CA
106H00000X
Marriage & Family Therapist
Primary
T0563
OR
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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