Individual
LAURA BLAKE TAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 MONROE ST, MEDFORD, OR 97501-3522
(541) 608-6868
Mailing address
500 MONROE ST, MEDFORD, OR 97501-3522
(541) 608-6868
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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