BLACK LOTUS THERAPY is a mental health counselor in Medford, OR. BLACK LOTUS THERAPY NPI is 1720696289. The provider is registered as an organization entity type and is a multi-specialty group.
The provider's business location address is:
10 CRATER LAKE AVE STE 25
MEDFORD, OR
ZIP 97504-445
Phone: (541) 500-8655
Fax: (800) 433-1396
The provider's authorized official is Tristin Victor .
The authorized official title is Owner and has the following contact phone number (541) 500-8655.
The enumeration date for this NPI number is 7/21/2020 and was last updated on 3/4/2021.