Doctor Name: | MS. SUSANNAH JANE ELDER |
NPI Number: | 1518039890 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T., NCBTMB |
License Number: | 10482 |
Business Practice Address: | 832 E Main St Ste. 6 Medford, OR - 975047153 |
Business Phone Number: | 5417725939 |
Business Fax Number: | 5417705939 |
Mailing Address: | 832 E Main St, Ste. 6 MEDFORD |
State: | OR |
Postal Code: | 975047153 |
Phone Number: | 5417725939 |
Fax Number: | 5417705939 |
NPI Enumeration Date: | 11/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 10482 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |