Provider Demographics
NPI:1376213330
Name:MASTERS, DANI RAE (EDS)
Entity type:Individual
Prefix:
First Name:DANI
Middle Name:RAE
Last Name:MASTERS
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4243
Mailing Address - Country:US
Mailing Address - Phone:541-790-7831
Mailing Address - Fax:
Practice Address - Street 1:200 N MONROE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4243
Practice Address - Country:US
Practice Address - Phone:541-790-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR549153103TS0200X
SC306361103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool