Individual
REGINA L JOLLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RC
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 684-4597
Mailing address
606 S ADAMS ST, REPUBLIC, WA 99166-8804
(509) 775-2504
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RC00055894
WA
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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