Most Relevant Information
Provider Data
| NPI Number: | 1003488420 |
| Provider Name: | JOSE ANTONIO MORA SANTANA LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | R5467 |
Most Important Dates
| Enumeration Date: | 07/14/2021 |
| Last Updated: | 07/14/2021 |
Provider Practice Location
66 CLUB RD STE 120
EUGENE
OR
974012439
Practice Location Phone/Fax
| Phone: | 6413935983 |
| Fax: |
Provider Mailing Location
355 S 34TH ST
SPRINGFIELD
OR
974786310
Provider Mailing Phone/Fax
| Phone: | 5415152679 |
| Fax: |