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1063855443
DERRICK KINLEY
GRANTS PASS, OR
NPI
1063855443
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2013-04-16
Last Update Date
2013-04-16
Business Address
DERRICK KINLEY
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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Mailing Address
DERRICK KINLEY
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
Copy
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