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NPI Code Detail

MEDICARE: KELSIE BRIANNE FERGUSSON QMHA

MEDICARE: KELSIE BRIANNE FERGUSSON QMHA
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 CounselorOR

General Provider Information

NPI Number : 1639848971
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSIE BRIANNE FERGUSSON QMHA
Provider Business Mailing Address
First Line : 318 PALM AVE APT C
Second Line :
City : ASHLAND
State : OR
Zip : 97520-3900
Country : US
Telephone Number : 971-272-6101
Fax Number :
Provider Business Practice Location Address
First Line : 4439 HAMRICK RD
Second Line :
City : CENTRAL POINT
State : OR
Zip : 97502-2816
Country : US
Telephone Number : 541-727-7669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2021
Last Update Date : 09/09/2021

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Directions to “ KELSIE BRIANNE FERGUSSON QMHA” Practice Location

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