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Organization
WATER CUP COUNSELING
Active
Organization
WATER CUP COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY WILLIAM GRIDLEY D.MIN. (LMFT THERAPIST.)
(541) 527-5802
Entity
Organization
Contact information
Practice address
852 SW 15TH ST, REDMOND, OR 97756-2507
(541) 527-5802
(541) 526-0300
Mailing address
2318 SE JEFFERSON DR, PRINEVILLE, OR 97754-8891
(541) 527-5802
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-1233
OR
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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