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Individual

SONIA L HUMEREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 476-2373
Mailing address
432 CAMBRIDGE AVE, 1215 SW G STREET, GRANTS PASS, OR 97526
(541) 476-2373

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
Primary
0092281
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
46300
NM
05
76955869
NM
Enumeration date
11/07/2006
Last updated
01/17/2019
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