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1588425235
TIMOTHY KYLE FRIEND
GRANTS PASS, OR
NPI
1588425235
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 23-CRM-1614)
Enumeration Date
2024-01-19
Last Update Date
2024-01-19
Business Address
TIMOTHY KYLE FRIEND
1885 NE 7TH ST
GRANTS PASS, OR 97526-3403
Phone number: 541-955-3210
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Mailing Address
TIMOTHY KYLE FRIEND
1885 NE 7TH ST
GRANTS PASS, OR 97526-3403
Phone number: 541-955-3210
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