Individual
DR. LANI C. FUJITSUBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
229 ERIC CT, MEDFORD, OR 97504-9053
(541) 772-7770
Mailing address
229 ERIC CT, MEDFORD, OR 97504-9053
(541) 772-7770
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1165
OR
Other
Enumeration date
05/18/2009
Last updated
05/18/2009
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