Individual provider · Type 1 NPI

Ethan Deghelder

Mental Health Counselor · Springfield, OR

NPI number 1124773148 Active

Practice location

3825 International Ct
Springfield, OR 97477-1086

Call (541) 858-8170 Map

Fax (541) 858-8167

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XPROFESSIONALLICENSE

Mental Health Counselor: Definition to come...

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About NPI 1124773148

Ethan Deghelder's National Provider Identifier is 1124773148, issued on Feb 17, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Springfield, OR. The record was last updated on May 16, 2023.