Individual
MS. LISA MARIE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,QMHP, CSWA, CADC
Contact information
Practice address
11 SW BRANTLEY DR, WINSTON, OR 97496-4526
(541) 679-0366
(541) 679-4821
Mailing address
11 SW BRANTLEY DR, WINSTON, OR 97496-4526
(541) 679-0366
(541) 679-4821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-02-24
OR
Other
Enumeration date
02/04/2016
Last updated
05/18/2021
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