Organization
POTENTIAL UNLIMITED
Active
Other names
ADD/ADHD Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C BERRYHILL LPC (CLINIC DIRECTOR)
(541) 482-2780
Entity
Organization
Contact information
Practice address
850 SISKIYOU BLVD, SUITE 9, ASHLAND, OR 97520-2125
(541) 482-2780
(541) 482-2780
Mailing address
PO BOX 1316, ASHLAND, OR 97520-0044
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0060
OR
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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