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NPI Code Detail

MEDICARE: KATHRYN MEZA

MEDICARE: KATHRYN MEZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1346549656
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MEZA
Provider Business Mailing Address
First Line : 3587 HEATHROW WAY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4004
Country : US
Telephone Number : 541-858-8170
Fax Number :
Provider Business Practice Location Address
First Line : 503 AIRPORT RD STE 101
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4159
Country : US
Telephone Number : 541-200-2900
Fax Number : 541-200-2948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2011
Last Update Date : 08/06/2020

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Directions to “ KATHRYN MEZA ” Practice Location

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