Individual
MRS. ELIZABETH JO SHERIDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
1555 SW 35TH ST, CORVALLIS, OR 97333-1130
(541) 757-5811
Mailing address
7170 SE SARAH DR, ADAIR VILLAGE, OR 97330-6576
(503) 539-6090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A5285
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407119134
—
OR
Enumeration date
06/18/2012
Last updated
08/27/2021
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