Individual
LAURA GLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
1720 MINDA DR, EUGENE, OR 97401-1933
(520) 818-8838
Mailing address
1720 MINDA DR, EUGENE, OR 97401-1933
(541) 267-2113
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C8120
OR
Other
Enumeration date
02/07/2024
Last updated
09/09/2024
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