Individual
MS. BREANNA MARIAH TUPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
THW
Contact information
Practice address
2073 OLYMPIC ST, SPRINGFIELD, OR 97477-3413
(541) 682-3550
Mailing address
151 W 7TH AVE STE 163, EUGENE, OR 97401-2676
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
175T00000X
Peer Specialist
Primary
THW000003582
OR
Other
Enumeration date
08/14/2019
Last updated
09/16/2021
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