Robertson, Jill

Robertson, Jill is an individual health care provider with primary practice located at 1345 Birch Street , Cottage Grove OR 97424-1307. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Robertson, Jill can be contacted via phone (541) 942-2850.

Contact Information

Primary practice address
1345 Birch Street Cottage Grove OR 97424-1307
Fax: (541) 942-1574
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1871642942
LBN Legal business name Robertson, Jill
Credentials LPC, QMHP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Mar 19th, 2014 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1871642942 NPPES
Oregon MEDICAID 019047

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