Individual
LACY BENOIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
11211 SE 82ND AVE STE O, HAPPY VALLEY, OR 97086-7624
(503) 722-6200
(503) 722-6545
Mailing address
2051 KAEN RD STE 367, OREGON CITY, OR 97045-4035
(503) 742-5300
(503) 742-5979
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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