Broderick R States
Broderick R States is a Mental Health Counselor in Medford, Oregon. Registered with an NPI since 2019.
- In the registry since
- 2019
Practice location Address checks out
3200 Juanipero WayMedford, OR 97504
Phone: (541) 816-4131
Fax: (458) 226-2163
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1073178794 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 8, 2019 |
| Last updated in NPPES | May 8, 2019 |
| Mailing address | 3587 Heathrow Way, Medford, OR 97504-4004 |
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