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1063158459
CRYSTAL ARLENE MOAN
ROSEBURG, OR
NPI
1063158459
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-21-566)
Enumeration Date
2022-05-09
Last Update Date
2022-05-09
Business Address
CRYSTAL ARLENE MOAN
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-440-3532
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Mailing Address
CRYSTAL ARLENE MOAN
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number: 541-440-3552
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