Provider Demographics
NPI:1295042265
Name:WATKINS, MARJORIE LUCILLE
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:LUCILLE
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2869
Mailing Address - Country:US
Mailing Address - Phone:541-743-4340
Mailing Address - Fax:541-743-4369
Practice Address - Street 1:315 W BROADWAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2869
Practice Address - Country:US
Practice Address - Phone:541-743-4340
Practice Address - Fax:541-743-4369
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2010-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor