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1851982383
JOSEPH RONALD WICKS
COBURG, OR
NPI
1851982383
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR T-21-562)
Enumeration Date
2021-01-28
Last Update Date
2021-01-28
Business Address
JOSEPH RONALD WICKS
1 SERENITY LN
COBURG, OR 97408-9350
Phone number: 541-687-1110
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Mailing Address
JOSEPH RONALD WICKS
1 SERENITY LN
COBURG, OR 97408-9350
Phone number: 541-687-1110
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