| Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon | |
|
33 N Central Ave Ste 317 Medford OR 97501-5939 | |
| (541) 227-2808 | |
| (541) 227-2807 |
| Full Name | Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 33 N Central Ave Ste 317, Medford, Oregon |
| Authorized Official Name and Position | Jennifer Boudreaux (OWNER/PROVIDER) |
| Authorized Official Contact | 5413243648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon 33 N Central Ave Ste 317 Medford OR 97501-5939 Ph: (541) 227-2808 | Pediatric Neurodevelopmental & Behavioral Clinic Of Southern Oregon 33 N Central Ave Ste 317 Medford OR 97501-5939 Ph: (541) 227-2808 |
| NPI Number | 1619791415 |
|---|---|
| Provider Enumeration Date | 11/09/2024 |
| Last Update Date | 11/09/2024 |
| Certification Date | 11/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619791415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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