Organization
FLOSS MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA WITHAM FNP-C, PMHNP-BC (OWNER/PROVIDER)
(503) 455-7656
Entity
Organization
Contact information
Practice address
753 SE MAIN ST STE 205, ROSEBURG, OR 97470-3985
(503) 455-7656
(503) 457-0645
Mailing address
753 SE MAIN ST STE 205, ROSEBURG, OR 97470-3985
(503) 455-7656
(503) 457-0645
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
06/25/2024
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