Individual
MR. ANTHONY DE CORDOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, NCC, LPC
Contact information
Practice address
1320 W 2ND AVE, EUGENE, OR 97402-4127
(541) 359-7328
Mailing address
830 E 36TH PL, EUGENE, OR 97405-4522
(503) 928-2521
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R4652
OR
Other
Enumeration date
07/09/2018
Last updated
03/20/2020
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