Kimberly Ellyn Cohen Wasserman, LCSW
Social Worker, Clinical in Ashland, OR. Individual provider (NPI-1).
NPI number1124258348
StatusActive
Last updated in NPPESAug 1, 2019
Details
- NPI
- 1124258348
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kimberly Ellyn Cohen Wasserman
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 22, 2009
- Last updated
- Aug 1, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | L2754 | OR | Yes |
Practice location
99 Central AveAshland, OR 97520-1787
Phone 541-482-9741 · Fax 541-488-6141
Mailing address
900 E Main StMedford, OR 97504-7136
Phone 541-200-6854
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