Individual
GINA MARIE ALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
390 1ST ST SW, SUITE 2B, BANDON, OR 97411-4500
(541) 329-0555
Mailing address
PO BOX 1387, BANDON, OR 97411-1387
(541) 329-0555
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
636
AK
101YP2500X
Professional Counselor
Primary
C2507
OR
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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