Individual
TAWNYA FREUDENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCI
Contact information
Practice address
418 SW 6TH STREET, GRANTS PASS, OR 97526
(541) 450-9615
Mailing address
418 SW 6TH ST, GRANTS PASS, OR 97526
(541) 450-9615
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-02-19
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
93-1200332
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871703702
—
OR
Enumeration date
03/24/2015
Last updated
04/27/2022
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