Bennett, Autumn Elizabeth Grace

Bennett, Autumn Elizabeth Grace is an individual health care provider with primary practice located at 300 W Main St , Medford OR 97501-2756. She recently has 2 registered licenses in different health care specialties including Technologists, Technicians & Other Technical Service Providers / Technician, Health Information, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Bennett, Autumn Elizabeth Grace can be contacted via phone (541) 200-2391.

Contact Information

Primary practice address
300 W Main St Medford OR 97501-2756
Phone: (541) 200-2391
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Health Information 247000000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1497293500
LBN Legal business name Bennett, Autumn Elizabeth Grace
Credentials CADC-R
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2017
Last updated Jan 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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