Individual
SEAN MICHAEL CONNOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/22/2011
Last updated
12/11/2014
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