Individual
JAIMIE BROADHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
261 E 12TH AVE # 200, EUGENE, OR 97401-3208
(541) 900-4285
Mailing address
261 E 12TH AVE # 200, EUGENE, OR 97401-3208
(541) 900-4285
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
C10042
OR
Other
Enumeration date
02/20/2014
Last updated
06/02/2025
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