Individual
MS. MARY ADRIENNE FANSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1237 N RIVERSIDE AVE, SUITE 229, MEDFORD, OR 97501
(541) 500-8655
Mailing address
PO BOX 1787, MEDFORD, OR 97501-0261
(541) 500-8655
(800) 433-1396
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L2117
OR
Other
Enumeration date
02/24/2006
Last updated
01/31/2025
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