Individual
MS. CORLISS HELEN MOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2000 OAKWOOD DR, MEDFORD, OR 97504-7635
(719) 650-1715
(503) 419-4662
Mailing address
PO BOX 503010, WHITE CITY, OR 97503-0813
(541) 941-7792
(503) 419-4662
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10164
CO
101YM0800X
Mental Health Counselor
Primary
C3213
OR
Other
Enumeration date
09/11/2008
Last updated
01/15/2014
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