Individual
ANDREW STUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1040 CRATER LAKE AVE STE D, MEDFORD, OR 97504-6295
(541) 500-8655
(800) 433-1396
Mailing address
PO BOX 1787, MEDFORD, OR 97501-0261
(541) 500-8655
(800) 433-1396
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C4877
OR
Other
Enumeration date
12/15/2014
Last updated
01/29/2024
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