Most Relevant Information
Provider Data
| NPI Number: | 1003340951 |
| Provider Name: | DENISE R. GAUDETTE |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/18/2017 |
| Last Updated: | 08/06/2021 |
Provider Practice Location
555 MAIN ST
SPRINGFIELD
OR
974775470
Practice Location Phone/Fax
| Phone: | 5413936452 |
| Fax: |
Provider Mailing Location
PO BOX 1401
SPRINGFIELD
OR
974770159
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |