LACY RENEE BANUELOS
Individual Provider (NPI-1)
Active
Counselor, Mental Health
Provider Information
- NPI Number
1760072086- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1545 HARBECK RD, GRANTS PASS, OR, 975275605
- Phone
- (541) 476-2373
Specialties & Taxonomies
Counselor, Mental Health
Primary