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1760955272
BRYANNA MARIE JELLUM
KELSO, WA
NPI
1760955272
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 60279397)
Enumeration Date
2019-01-07
Last Update Date
2021-04-21
Business Address
BRYANNA MARIE JELLUM SUDP
404 W MAIN ST
KELSO, WA 98626-1118
Phone number: 360-423-2806
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Mailing Address
BRYANNA MARIE JELLUM SUDP
404 W MAIN ST
KELSO, WA 98626-1118
Phone number: 360-423-2806
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