Organization
BRINK OF BRILLIANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE R GAUDETTE LPC (OWNER)
(541) 393-6452
Entity
Organization
Contact information
Practice address
555 MAIN ST, SPRINGFIELD, OR 97477-5470
(541) 393-6452
Mailing address
PO BOX 1401, SPRINGFIELD, OR 97477-0159
(541) 393-6452
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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