Individual
KELLY DIANE WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
115 W 8TH AVE, EUGENE, OR 97401-2961
(541) 505-8168
Mailing address
1741 E 25TH AVE, EUGENE, OR 97403-1806
(541) 556-9089
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
OR
Enumeration date
05/14/2021
Last updated
12/06/2024
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