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Individual

SADIE TEAGAN ANGELIQUE SOUZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
15 CRATER LAKE AVE, MEDFORD, OR 97504-7444
(541) 227-6687
Mailing address
PO BOX 1787, MEDFORD, OR 97501-0261
(541) 500-8655
(800) 433-1396

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C9710
OR

Other

Enumeration date
05/28/2020
Last updated
12/26/2025
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