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Individual

AMY DAHLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, LPCC

Contact information

Practice address
140 S HOLLY ST, MEDFORD, OR 97501-3113
(541) 774-8201
(541) 774-7979
Mailing address
1467 SISKIYOU BLVD # 518, ASHLAND, OR 97520-2336
(541) 363-7309

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
15947
CA
101YP2500X
Professional Counselor
Primary
C4743
OR

Other

Enumeration date
09/09/2015
Last updated
03/05/2024
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