Organization
CONNIE J KERSENBROCK, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE KERSENBROCK LCSW (OWNER)
(620) 966-6925
Entity
Organization
Contact information
Practice address
300 SE REED MARKET RD STE 110, BEND, OR 97702-2237
(620) 966-6925
Mailing address
130 SW CANYON DR APT 3, REDMOND, OR 97756-2054
(620) 966-6925
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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