Healthcare Provider Details

I. General information

NPI: 1700906443
Provider Name (Legal Business Name): EMILYANN RITZMAN LEGRUE MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMILYANN RITZMAN

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 PEARL ST STE 6
EUGENE OR
97401-3642
US

IV. Provider business mailing address

3901 CENTURY DR
EUGENE OR
97402-8240
US

V. Phone/Fax

Practice location:
  • Phone: 541-844-8910
  • Fax:
Mailing address:
  • Phone: 541-844-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: