Individual
KAILY RAE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
352 S CALAPOOIA ST STE B, SUTHERLIN, OR 97479-9558
(541) 799-5386
Mailing address
1255 PEARL ST STE 101, EUGENE, OR 97401-3570
(541) 799-5386
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
11/01/2022
Last updated
11/12/2025
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