Individual
JENNY MARIE WOLLEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1646 NE EDGECLIFF CIR, BEND, OR 97701-4159
(971) 506-5366
Mailing address
20800 COMET LN UNIT 2, BEND, OR 97701-6909
(971) 506-5366
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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