Provider Information for 1174714596
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Ms. PATTY EARL L.P.C., M.S., QMHP
Sex: Female
NPI: 1174714596
Last Updated: 2007-08-09
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174714596 | ||||||||
| Enumeration Date | 2007-08-09 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 37875 JASPER LOWELL RD JASPER, OR 97438-9751 United States Phone: 541-747-1235 | Fax:541-747-4722 | ||||||||
| Primary Practice Address | 37875 JASPER LOWELL RD JASPER, OR 97438-9751 United States Phone: 541-747-1235 | Fax:541-747-4722 | ||||||||
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