Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003236803 |
---|---|
Provider Name | Lindsey Michelle Persinger |
First Address | Medford, OR 97504-4004 |
Second Address | Medford, OR 97504-4159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 16/03/2020 |