Provider Demographics
NPI:1518784800
Name:DEPRETER, DANA M (CSWA)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:M
Last Name:DEPRETER
Suffix:
Gender:F
Credentials:CSWA
Other - Prefix:MS
Other - First Name:DANA
Other - Middle Name:M
Other - Last Name:DEPRETER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1834 MCPHERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459
Mailing Address - Country:US
Mailing Address - Phone:541-267-2113
Mailing Address - Fax:541-267-5071
Practice Address - Street 1:1834 MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459
Practice Address - Country:US
Practice Address - Phone:541-267-2113
Practice Address - Fax:541-267-5071
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA15664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health