Carl Richardson, QMHA
Counselor, Mental Health in Medford, OR. Individual provider (NPI-1).
NPI number1275212904
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1275212904
- Entity type
- Individual (NPI-1)
- Name
- Carl Richardson
- Credential
- QMHA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2023
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
200 Beatty StMedford, OR 97501-5811
Phone 541-476-2373
Mailing address
1215 Sw G StGrants Pass, OR 97526-2544
Phone 541-476-2373
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