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1972884427
MIMI KOONTZ
EUGENE, OR
NPI
1972884427
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L4711)
Enumeration Date
2011-08-29
Last Update Date
2014-07-15
Business Address
-- MIMI KOONTZ LCSW
550 RIVER RD
EUGENE, OR 97404-3212
Phone number: 541-743-2611
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Mailing Address
-- MIMI KOONTZ LCSW
550 RIVER RD
EUGENE, OR 97404-3212
Phone number: 541-743-2611
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