Provider Demographics
NPI:1407981822
Name:OVERTON, KAMBER DAWN
Entity Type:Individual
Prefix:
First Name:KAMBER
Middle Name:DAWN
Last Name:OVERTON
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 1:325 S 5TH ST
Mailing Address - Street 2:APT.#47
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-2170
Mailing Address - Country:US
Mailing Address - Phone:541-946-1124
Mailing Address - Fax:541-334-0680
Practice Address - Street 1:689 W 13TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4089
Practice Address - Country:US
Practice Address - Phone:541-345-4244
Practice Address - Fax:541-686-0359
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health