Individual
CRYSTELL ANNETTE ALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(458) 212-9986
Mailing address
300 W MAIN ST, MEDFORD, OR 97501-2756
(458) 212-9986
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-22-1959
OR
247000000X
Health Information Technician
—
—
Other
Enumeration date
06/02/2021
Last updated
09/21/2022
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