Provider Demographics
NPI:1629485560
Name:REYES, ELIZABETH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 W 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3008
Mailing Address - Country:US
Mailing Address - Phone:541-279-2245
Mailing Address - Fax:541-804-7380
Practice Address - Street 1:243 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3008
Practice Address - Country:US
Practice Address - Phone:541-279-2245
Practice Address - Fax:541-804-7380
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
ORT1363106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist