Individual
TERESA M PERSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
1590 SE N ST STE D, GRANTS PASS, OR 97526-3905
(541) 621-2686
Mailing address
1590 SE N ST STE D, GRANTS PASS, OR 97526-3905
(541) 621-2686
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C2034
OR
Other
Enumeration date
03/20/2007
Last updated
04/18/2013
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