Organization
SOUTH VALLEY THERAPY, LLC
Active
Other names
Davide J. Costley
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAVIDE J COSTLEY LPC (OWNER)
(541) 525-1010
Entity
Organization
Contact information
Practice address
1991 GARDEN AVE, EUGENE, OR 97403-1934
(541) 525-1010
Mailing address
5649 E ST, SPRINGFIELD, OR 97478-5417
(541) 525-1010
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500662974
—
OR
Enumeration date
09/28/2020
Last updated
09/28/2020
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