Individual
MISS LAURIE JANE WILMOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CADCIII
Contact information
Practice address
1345 NW WALL ST STE 201, BEND, OR 97701-1967
(541) 280-1570
Mailing address
1225 NW JACKSONVILLE AVE, BEND, OR 97701-2228
(541) 280-1570
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4105
OR
Other
Enumeration date
09/02/2009
Last updated
05/16/2013
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