Individual
KELLEY STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, CCS
Contact information
Practice address
100 MULLINS DR STE C2, LEBANON, OR 97355-2868
(541) 451-6388
Mailing address
100 MULLINS DR STE C2, LEBANON, OR 97355-2868
(541) 451-6388
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-R-34
OR
Other
Enumeration date
01/31/2007
Last updated
09/13/2018
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