Provider Demographics
NPI:1083437438
Name:THOMPSON, DRENNA (MENTAL HEALTH INTERN)
Entity type:Individual
Prefix:
First Name:DRENNA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MENTAL HEALTH INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24615 W DEMMING RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:OR
Mailing Address - Zip Code:97437-9620
Mailing Address - Country:US
Mailing Address - Phone:541-650-1992
Mailing Address - Fax:
Practice Address - Street 1:777 HIGH ST STE 130
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2750
Practice Address - Country:US
Practice Address - Phone:541-216-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health