Individual
JENNIFER MIATKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, MDIV, CADCI
Contact information
Practice address
18 PORTLAND AVE, MEDFORD, OR 97504-7309
(541) 613-2697
(541) 245-1530
Mailing address
15097 HIGHWAY 66, ASHLAND, OR 97520-9400
(541) 613-2697
(541) 245-1530
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C3620
OR
101YP2500X
Professional Counselor
Primary
C3620
OR
Other
Enumeration date
03/13/2015
Last updated
03/29/2024
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