Individual
EBONY LEREE SHORTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
(541) 426-3035
Mailing address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
(541) 426-3035
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
L15279
OR
1041C0700X
Clinical Social Worker
Primary
34010647A
IN
Other
Enumeration date
10/18/2023
Last updated
09/04/2025
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