Individual
STACY JO BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1350033502
UT
Other
Enumeration date
11/09/2006
Last updated
12/22/2014
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