Most Relevant Information
Provider Data
| NPI Number: | 1003580424 |
| Provider Name: | YVONNE SERENA ACKISON |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/09/2021 |
| Last Updated: | 08/09/2021 |
Provider Practice Location
503 AIRPORT RD STE 101
MEDFORD
OR
975044159
Practice Location Phone/Fax
| Phone: | 5412002900 |
| Fax: | 5412002948 |
Provider Mailing Location
3587 HEATHROW WAY
MEDFORD
OR
975044004
Provider Mailing Phone/Fax
| Phone: | 5418588170 |
| Fax: | 5418588167 |