Individual
MILANA MARIE MARSENICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
379
MT
101YP2500X
Professional Counselor
Primary
C5643
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253357
—
MT
01
—
742830
BCBS PROVIDER NUMBER
MT
Enumeration date
09/24/2006
Last updated
07/03/2024
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