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1174253264
BENJAMIN A LA MAR
COOS BAY, OR
NPI
1174253264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2022-06-13
Last Update Date
2022-06-13
Business Address
BENJAMIN A LA MAR MSW Intern
375 PARK AVE STE 2
COOS BAY, OR 97420-2242
Phone number: 541-404-6238
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Mailing Address
BENJAMIN A LA MAR MSW Intern
63875 WALLACE RD
COOS BAY, OR 97420-8779
Phone number: 541-404-6238
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