ETHAN DEGHELDER

SPRINGFIELD, OR
NPI1124773148
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence:   professionallicense)
Enumeration Date2022-02-17
Last Update Date2023-05-16
Business Address
ETHAN DEGHELDER
3825 INTERNATIONAL CT
SPRINGFIELD, OR 97477-1086
Phone number: 541-858-8170
Mailing Address
ETHAN DEGHELDER
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170