Individual
PHAEDRA D HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
1025 E MAIN ST, MEDFORD, OR 97504
(541) 779-1282
(541) 608-2888
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 326-4905
(541) 608-2888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18-07-12
OR
Other
Enumeration date
05/13/2015
Last updated
08/01/2018
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