Provider Demographics
NPI:1699803106
Name:LLORENS, MARY BETH (PHD)
Entity type:Individual
Prefix:DR
First Name:MARY BETH
Middle Name:
Last Name:LLORENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-1634
Mailing Address - Country:US
Mailing Address - Phone:541-302-6439
Mailing Address - Fax:
Practice Address - Street 1:2690 EMERALD ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-1634
Practice Address - Country:US
Practice Address - Phone:541-302-6439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1440103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical