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Leslie Wayne Holbrook
Peer Specialist in White City, Oregon
NPI 1912783770

Leslie Wayne Holbrook is a Peer Specialist based in White City, OR. Leslie Wayne Holbrook practices in White City, OR. The NPI Number for Leslie Wayne Holbrook is 1912783770 and holds a License No. (Oregon).

The current practice location address for Leslie Wayne Holbrook is 8495 Crater Lake Hwy, White City, OR and can be reached out via phone at 541-826-2111 and via fax at 541-830-3516.

Location: 8495 Crater Lake Hwy, White City, OR, 97503-3011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1912783770
Provider Name
Leslie Wayne Holbrook
Credential
Provider Entity Type
Individual
Gender
Male
Address
8495 Crater Lake Hwy, White City, OR, 97503-3011
Phone Number
541-826-2111
Fax Number
541-830-3516
Provider Enumeration Date
09/06/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
THW00003281 01 OR CERTIFIED PEER SPECIALIST
institution
Provider Business Practice Location Address Details
Address
8495 Crater Lake Hwy
City
White City
State
Oregon
Zip
97503-3011
Phone Number
541-826-2111
Fax Number
541-830-3516
person
Provider Business Mailing Address Details
Address
8495 Crater Lake Hwy
City
White City
State
Oregon
Zip
97503-3011
Phone Number
541-826-2111
Fax Number
541-830-3516
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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