Individual
BRIAN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I
Contact information
Practice address
195 W 12TH AVE, EUGENE, OR 97401-3408
(541) 762-4300
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 684-4148
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-12-37
OR
101YM0800X
Mental Health Counselor
13-12-37
OR
Other
Enumeration date
03/17/2014
Last updated
05/17/2016
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