Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003124603 |
---|---|
Provider Name | Jennifer Karen Gerrard |
First Address | Eugene, OR 97405-2247 |
Second Address | Eugene, OR 97405-1663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2010 |
Last Update Date | 16/09/2010 |