LARISA IVANA CZERNOWSKI

ROSEBURG, OR
NPI1215672837
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-22-1577)
Enumeration Date2022-04-28
Last Update Date2022-04-28
Business Address
LARISA IVANA CZERNOWSKI
2575 NW KLINE ST
ROSEBURG, OR 97471-8827
Phone number: 541-673-3504
Mailing Address
LARISA IVANA CZERNOWSKI
1455 SE MAIN ST
ROSEBURG, OR 97470-4213
Phone number: 541-670-4722
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