Provider Demographics
NPI:1619169190
Name:ESHELBRENNER, RAMA J (MA)
Entity Type:Individual
Prefix:MS
First Name:RAMA
Middle Name:J
Last Name:ESHELBRENNER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CENTRAL AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2316
Mailing Address - Country:US
Mailing Address - Phone:541-267-2113
Mailing Address - Fax:541-267-5071
Practice Address - Street 1:125 CENTRAL AVE
Practice Address - Street 2:SUITE 290
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2316
Practice Address - Country:US
Practice Address - Phone:541-267-2113
Practice Address - Fax:541-267-5071
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health