Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003191636 |
---|---|
Provider Name | Kelley Arena Foley |
First Address | Eugene, OR 97405-1663 |
Second Address | Eugene, OR 97405-1663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2011 |
Last Update Date | 14/04/2014 |