Individual provider · Type 1 NPI

Lacy Renee Banuelos

Mental Health Counselor · Grants Pass, OR

NPI number 1760072086 Active

Practice location

1545 Harbeck Rd
Grants Pass, OR 97527-5605

Call (541) 476-2373 Map

Mailing address

1215 SW G St
Grants Pass, OR 97526-2544

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1760072086

Lacy Renee Banuelos's National Provider Identifier is 1760072086, issued on Jan 20, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Grants Pass, OR. The record was last updated on Jan 20, 2021.