MEDICARE: MS. RENEE MARCY M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5035	OR

General Provider Information

NPI Number	:	1477670032
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RENEE MARCY M.S.

Provider Business Mailing Address
First Line	:	180 W 23RD AVE
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-2854
Country	:	US
Telephone Number	:	541-343-1924
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 E 24TH AVE
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97405-2907
Country	:	US
Telephone Number	:	541-517-1201
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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