Individual
BRENDA MARIE WALLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 622-2186
(541) 770-9212
Mailing address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 622-2186
(541) 770-9212
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
MT-T-10179874
OR
Other
Enumeration date
05/22/2012
Last updated
07/21/2022
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