BLACK LOTUS THERAPY

MEDFORD, OR
NPI1720696289
Entity TypeOrganization
Authorized ContactTRISTIN VICTOR
Owner
541-500-8655
Organization Subpart ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2020-07-21
Last Update Date2021-03-04
Business Address
BLACK LOTUS THERAPY
10 CRATER LAKE AVE STE 25
MEDFORD, OR 97504-7445
Phone number: 541-500-8655
Mailing Address
BLACK LOTUS THERAPY
PO BOX 4752
MEDFORD, OR 97501-0197
Phone number: 541-500-8655
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