Individual
AUTUMN JOY OGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS, CRM, CADC-R
Contact information
Practice address
75 S 5TH ST, COTTAGE GROVE, OR 97424-2008
(541) 767-4260
Mailing address
519 S 3RD ST, COTTAGE GROVE, OR 97424-2405
(458) 867-1740
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
109502
OR
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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