Individual
BRITTNEY LETICIA VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
3156 STATE ST, MEDFORD, OR 97504-8450
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
ABA-IN-10198018
OR
Other
Enumeration date
02/13/2019
Last updated
05/06/2019
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