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1487472320
KELLY LAURA LACOST
EUGENE, OR
NPI
1487472320
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR 110535)
Enumeration Date
2024-09-30
Last Update Date
2024-09-30
Business Address
KELLY LAURA LACOST THW, PSS
261 E 12TH AVE
EUGENE, OR 97401-3208
Phone number: 541-780-4277
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Mailing Address
KELLY LAURA LACOST THW, PSS
1258 HIGH ST
EUGENE, OR 97401-3238
Phone number: 541-337-1902
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