Individual
MRS. CAROL LYNN WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W
Contact information
Practice address
1911 UNITED WAY, MEDFORD, OR 97504-4970
(541) 301-7030
(541) 301-7030
Mailing address
2198 E MCANDREWS RD, MEDFORD, OR 97504-5579
(541) 301-7030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4840
OR
Other
Enumeration date
10/26/2017
Last updated
10/26/2017
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