Individual
MILTON TAULBEE MCCUISTION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
1175 E MAIN ST STE 1C, MEDFORD, OR 97504-7457
(541) 772-0127
(541) 772-0966
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 956-4943
(541) 956-3085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/27/2015
Last updated
07/21/2022
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