Organization
PEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON
Active
Organization
PEDIATRIC NEURODEVELOPMENTAL & BEHAVIORAL CLINIC OF SOUTHERN OREGON
Active
Parent organization
JENNIFER K BOUDREAUX, CPNP, PMHS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JENNIFER K BOUDREAUX, CPNP, PMHS, LLC
Authorized official
JENNIFER BOUDREAUX MSN, CPNP, PMHS (OWNER/PROVIDER)
(541) 324-3648
Entity
Organization
Contact information
Practice address
33 N CENTRAL AVE STE 317, MEDFORD, OR 97501-5939
(541) 227-2808
(541) 227-2807
Mailing address
33 N CENTRAL AVE STE 317, MEDFORD, OR 97501-5939
(541) 227-2808
(541) 227-2807
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/09/2024
Last updated
11/09/2024
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