person
Broderick R States
Mental Health Counselor in Medford, Oregon
NPI 1073178794

Broderick R States is a Mental Health Counselor based in Medford, OR and is specialized in Mental Health. Broderick R States practices in Medford, OR. The NPI Number for Broderick R States is 1073178794 and holds a License No. (Oregon).

The current practice location address for Broderick R States is 3200 Juanipero Way, Medford, OR and can be reached out via phone at 541-816-4131 and via fax at 458-226-2163.

Location: 3200 Juanipero Way, Medford, OR, 97504-4004
person
Provider Profile Details
NPI Number
1073178794
Provider Name
Broderick R States
Credential
Provider Entity Type
Individual
Gender
Male
Address
3200 Juanipero Way, Medford, OR, 97504-4004
Phone Number
541-816-4131
Fax Number
458-226-2163
Provider Enumeration Date
05/08/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3200 Juanipero Way
City
State
Zip
97504
Phone Number
541-816-4131
Fax Number
458-226-2163
person
Provider Business Mailing Address Details
Address
3200 Juanipero Way
City
State
Zip
97504
Phone Number
541-816-4131
Fax Number
458-226-2163
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
()
Definition
Definition to come...
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