MEDICARE: GUY PRESKENIS PERRIN LPC

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	101YP2500X	Professional Counselor	C2300	OR

General Provider Information

NPI Number	:	1962732479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUY PRESKENIS PERRIN LPC

Provider Business Mailing Address
First Line	:	295 E MAIN ST
Second Line	:	#9
City	:	ASHLAND
State	:	OR
Zip	:	97520-1848
Country	:	US
Telephone Number	:	541-245-0789
Fax Number	:

Provider Business Practice Location Address
First Line	:	295 E MAIN ST
Second Line	:	#9
City	:	ASHLAND
State	:	OR
Zip	:	97520-1848
Country	:	US
Telephone Number	:	541-245-0789
Fax Number	:	866-454-9789

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

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	01/05/2010

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Directions to “ GUY PRESKENIS PERRIN LPC” Practice Location

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