Gwyther, Deidra Aubrey

Gwyther, Deidra Aubrey is an individual health care provider with primary practice located at 175 W B St Ste I , Springfield OR 97477-4575. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Gwyther, Deidra Aubrey can be contacted via phone (541) 988-1025.

Contact Information

Primary practice address
175 W B St Ste I Springfield OR 97477-4575
Phone: (541) 988-1025
Fax: (541) 844-1051
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1962669218
LBN Legal business name Gwyther, Deidra Aubrey
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2008
Last updated Nov 4th, 2019 - about 7 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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Identifiers

StateTypeNumberIssuer
All States NPI 1962669218 NPPES
Oregon MEDICAID 241382

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