LACY PREMO

Counselor - Mental Health

Active Individual
NPI: 1023749736

Practice Address

29845 AIRPORT WAY
Gold Beach, OR 97444

Phone: (541) 708-9582

Specialties

Specialty Code Primary License
Counselor - Mental Health 101YM0800X Yes -

Frequently Asked Questions

NPI 1023749736 is the National Provider Identifier for LACY PREMO, a Counselor - Mental Health provider located in Gold Beach, OR. This NPI was enumerated on June 22, 2022.
LACY PREMO practices at 29845 AIRPORT WAY, Gold Beach, OR 97444.

Quick Facts

NPI
1023749736
Type
Individual
Enumerated
Jun 22, 2022
Last Updated
Jun 17, 2025

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