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1437761301
DEIRDRAH RENEE RACINE
ROSEBURG, OR
NPI
1437761301
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR Intern)
Enumeration Date
2020-08-20
Last Update Date
2020-08-20
Business Address
DEIRDRAH RENEE RACINE QMHP
850 SE ROSE ST
ROSEBURG, OR 97470-3942
Phone number: 541-900-1506
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Mailing Address
DEIRDRAH RENEE RACINE QMHP
850 SE ROSE ST
ROSEBURG, OR 97470-3942
Phone number: 541-900-1506
Copy
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