Individual
MS. LAURIE L. THEODOROU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
724 S CENTRAL AVE, SUITE 214, MEDFORD, OR 97501-7851
(541) 858-7916
Mailing address
724 S CENTRAL AVE, SUITE 214, MEDFORD, OR 97501-7851
(541) 858-7916
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3373
OR
Other
Enumeration date
11/28/2009
Last updated
11/28/2009
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