Individual
MS. MARY CARROLL BURNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, CRC
Contact information
Practice address
82811 MARLOW RD, EUGENE, OR 97405-9722
(541) 525-5302
Mailing address
PO BOX 50581, EUGENE, OR 97405-0985
(541) 525-5302
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CRC 47784
—
104100000X
Social Worker
Primary
6323
KY
Other
Enumeration date
06/11/2013
Last updated
06/11/2013
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