Individual
BENNETT ELIZABETH CORDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
2240 TERREL DR, MEDFORD, OR 97501-8140
(458) 226-5347
Mailing address
2240 TERREL DR, MEDFORD, OR 97501-8140
(458) 226-5347
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
24-QMHA-R-5600
OR
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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