IndividualActive
Aj Tedtaotao
NPI 1336871359 · Mental Health Counselor · Springfield, OR
Provider details
- NPI number
- 1336871359
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
Practice location
3995 Marcola Rd
Springfield, OR 97477-7948
Phone: (541) 726-1465
Fax: (541) 726-5085
Mailing address
3995 Marcola Rd
Springfield, OR 97477-7948
Registry dates
- Enumerated
- 2022-06-28
- Last updated
- 2025-01-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.