Individual provider · Type 1 NPI

Lisa Marie Root

Mental Health Counselor · Brookings, OR

NPI number 1366100174 Active

Practice location

210 Cove Rd
Brookings, OR 97415-2520

Call (541) 469-0222 Map

Fax (541) 469-0228

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1366100174

Lisa Marie Root's National Provider Identifier is 1366100174, issued on Nov 30, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Brookings, OR. The record was last updated on Nov 30, 2021.