Individual
BRANDON EDGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 E MAIN ST STE 2, MEDFORD, OR 97501-6022
(458) 225-0895
Mailing address
107 E MAIN ST STE 2, MEDFORD, OR 97501-6022
(458) 225-0895
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.011067
IL
101YP2500X
Professional Counselor
Primary
C4709
OR
Other
Enumeration date
05/01/2017
Last updated
12/21/2023
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