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1861890634
KELLIE JO DICKINSON
ONTARIO, OR
NPI
1861890634
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Former Name
KELLY JO GRAHAM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-12-10
Last Update Date
2014-12-10
Business Address
-- KELLIE JO DICKINSON
702 SUNSET DR
ONTARIO, OR 97914-3121
Phone number: 541-889-9167
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Mailing Address
-- KELLIE JO DICKINSON
702 SUNSET DR
ONTARIO, OR 97914-3121
Phone number: 541-889-9167
Copy
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