Individual
MISTY BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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