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1407111925
ERICA LYNN IDSO
MEDFORD, OR
NPI
1407111925
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: MN 2208)
Enumeration Date
2012-07-10
Last Update Date
2017-07-17
Business Address
Ms. ERICA LYNN IDSO MS, LMFT
19 MYRTLE ST
MEDFORD, OR 97504-7337
Phone number: 541-773-3863
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Mailing Address
Ms. ERICA LYNN IDSO MS, LMFT
900 E MAIN ST
MEDFORD, OR 97504-7136
Phone number: 541-842-7704
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