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Organization

ROBERT SKIDMORE PHD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT SKIDMORE LPC (OWNER)
(541) 500-8655
Entity
Organization

Contact information

Practice address
18 PORTLAND AVE, MEDFORD, OR 97504-7309
(541) 500-8655
Mailing address
PO BOX 4752, MEDFORD, OR 97501-0197
(541) 500-8655
(800) 433-1396

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500722503
OR
Enumeration date
12/04/2018
Last updated
12/04/2018
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