Provider Demographics
NPI:1932400124
Name:KUNTZ, PATRICIA ELAINE (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELAINE
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:KUNTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:27 MARLBORO LANE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3545
Mailing Address - Country:US
Mailing Address - Phone:458-206-1545
Mailing Address - Fax:
Practice Address - Street 1:27 MARLBORO LANE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3545
Practice Address - Country:US
Practice Address - Phone:458-206-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3865101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health