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Philip Broesamle
Addiction (Substance Use Disorder) Counselor in Shady Cove, Oregon
NPI 1427444264

Philip Broesamle is an Addiction (Substance Use Disorder) Counselor based in Shady Cove, OR and is specialized in Addiction (Substance Use Disorder). Philip Broesamle practices in Shady Cove, OR. The NPI Number for Philip Broesamle is 1427444264 and holds a License No. (Oregon).

The current practice location address for Philip Broesamle is 60 Mallory Ln., Shady Cove, OR and can be reached out via phone at 541-878-2658.

Location: 60 Mallory Ln., Shady Cove, OR, 97539
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427444264
Provider Name
Philip Broesamle
Credential
Provider Entity Type
Individual
Gender
Male
Address
60 Mallory Ln., Shady Cove, OR, 97539
Phone Number
541-878-2658
Fax Number
Provider Enumeration Date
04/08/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
60 Mallory Ln.
City
Shady Cove
State
Oregon
Zip
97539
Phone Number
541-878-2658
Fax Number
person
Provider Business Mailing Address Details
Address
60 Mallory Ln.
City
Shady Cove
State
Oregon
Zip
97539
Phone Number
541-878-2658
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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