Individual
MRS. CHERYL DIANE COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC II
Contact information
Practice address
837 E MAIN ST, MEDFORD, OR 97504-7151
(541) 772-2763
(541) 734-3161
Mailing address
837 E MAIN ST, MEDFORD, OR 97504-7151
(541) 772-2763
(541) 734-3161
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
06-03-54
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
060354
OR
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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