Individual
MRS. DEBORAH LUETKENHOELTER BENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A./CCC-SLP
Contact information
Practice address
675 N 5TH ST, JACKSONVILLE, OR 97530-9659
(541) 227-8307
Mailing address
1443 ELAINE WAY, MEDFORD, OR 97501-2890
(541) 219-6529
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10404
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00724153
AMERICAN SPEECH AND HEARING ASSOCIATION
—
01
—
10404
STATE OF OREGON PROFESSIONAL LICENSE
OR
Enumeration date
05/27/2008
Last updated
01/25/2016
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