Mudiam, Kavya

Mudiam, Kavya is an individual health care provider with primary practice located at 1 Serenity Ln , Coburg OR 97408-9350. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Mudiam, Kavya can be contacted via phone (615) 663-0773.

Contact Information

Primary practice address
1 Serenity Ln Coburg OR 97408-9350
Phone: (615) 663-0773
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 21-QMHA-R-1774 Oregon

Profile Details

NPI number 1508521733
LBN Legal business name Mudiam, Kavya
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2021
Last updated Jul 6th, 2023 - 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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