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Individual

DR. SCOTT A BANDOROFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYCHOLOGIST (PHD)

Contact information

Practice address
149 CLEAR CREEK DR, SUITE 110, ASHLAND, OR 97520
(541) 951-4329
(503) 419-4662
Mailing address
P.O. BOX 503010, X, WHITE CITY, OR 97503-0813
(541) 941-7792
(503) 419-4662

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
1120
OR
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
OR1120
OR

Other

Enumeration date
07/23/2007
Last updated
04/17/2012
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