Individual
DESIREE NICOLE MANTEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2145 CENTENNIAL PLZ, EUGENE, OR 97401-2421
(541) 543-0037
Mailing address
2145 CENTENNIAL PLZ, EUGENE, OR 97401-2421
(541) 543-0037
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A102722
OR
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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