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1922619105
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GRANTS PASS, OR
NPI
1922619105
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2020-08-12
Last Update Date
2020-08-12
Business Address
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1920 SW KURTZ LN
GRANTS PASS, OR 97526-2803
Phone number: 541-295-3072
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Mailing Address
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1750 NEBRASKA AVE BLDG A
GRANTS PASS, OR 97527-5700
Phone number: 541-956-4943
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