Provider Demographics
NPI:1164578936
Name:DURHAM, SHARON EILEEN (QMHA)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:EILEEN
Last Name:DURHAM
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-3832
Mailing Address - Country:US
Mailing Address - Phone:541-736-8582
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH
Practice Address - Street 2:SHELTERCARE
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402
Practice Address - Country:US
Practice Address - Phone:541-741-7726
Practice Address - Fax:541-741-8044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health