Most Relevant Information
Provider Data
| NPI Number: | 1003471319 |
| Provider Name: | SHOLANA SHOBERG |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/02/2019 |
| Last Updated: | 05/02/2019 |
Provider Practice Location
2020 THOMPSON RD
COOS BAY
OR
974202041
Practice Location Phone/Fax
| Phone: | 5412673511 |
| Fax: | 5412673512 |
Provider Mailing Location
1750 NEBRASKA AVE
GRANTS PASS
OR
975275700
Provider Mailing Phone/Fax
| Phone: | 5419564943 |
| Fax: | 5412953085 |