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1548629116
LAURA RAE FORTUNE
NORTH BEND, OR
NPI
1548629116
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-02-11
Last Update Date
2016-02-11
Business Address
Mrs. LAURA RAE FORTUNE CAC/CM
400 VIRGINIA AVE #201
NORTH BEND, OR 97459-2709
Phone number: 541-751-0357
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Mailing Address
Mrs. LAURA RAE FORTUNE CAC/CM
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-672-2691
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