Individual
AMY CAUDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT
Contact information
Practice address
850 SW 4TH ST, MADRAS, OR 97741-9628
(541) 475-6575
(541) 504-1195
Mailing address
PO BOX 1710, REDMOND, OR 97756-0516
(541) 516-4087
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000003653
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000003653
PEER SUPORT
OR
Enumeration date
06/27/2019
Last updated
06/27/2019
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