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1194363671
JENNIFER LYNNE DEATHERAGE
KLAMATH FALLS, OR
NPI
1194363671
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-12-16
Last Update Date
2020-01-10
Business Address
JENNIFER LYNNE DEATHERAGE CADCI Intern
2210 N ELDORADO AVE
KLAMATH FALLS, OR 97601-6418
Phone number: 541-883-1030
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Mailing Address
JENNIFER LYNNE DEATHERAGE CADCI Intern
2210 N ELDORADO AVE
KLAMATH FALLS, OR 97601-6418
Phone number: 541-883-1030
Copy
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