Individual
MR. JIM LAPORTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
63360 BRITTA ST STE 1, BEND, OR 97701-9475
(541) 322-7652
Mailing address
63360 BRITTA ST STE 1, BEND, OR 97701-9475
(541) 322-7652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2783
OR
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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