| Headwaters Therapy Llc | |
|
927 Country Club Rd Ste 200 Eugene OR 97401-2272 | |
| (541) 604-8822 | |
| (541) 359-1134 |
| Full Name | Headwaters Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 927 Country Club Rd Ste 200, Eugene, Oregon |
| Authorized Official Name and Position | Ryan S Smith (LICENSED MARRIAGE & FAMILY THERAPIS) |
| Authorized Official Contact | 5418682004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Therapy Llc 927 Country Club Rd Ste 200 Eugene OR 97401-2272 Ph: (541) 604-8822 | Headwaters Therapy Llc 927 Country Club Rd Ste 200 Eugene OR 97401-2272 Ph: (541) 604-8822 |
| NPI Number | 1538793591 |
|---|---|
| Provider Enumeration Date | 02/28/2020 |
| Last Update Date | 06/25/2020 |
| Certification Date | 06/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538793591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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