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Individual

KELLY CEGLARZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BCBA, LMFT

Contact information

Practice address
1252 NW ITHACA AVE, BEND, OR 97703-2221
(415) 870-4133
Mailing address
PO BOX 42, BEND, OR 97709-0042
(158) 704-1334

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-11-8061
CA
106H00000X
Marriage & Family Therapist
Primary
IMF66109
CA

Other

Enumeration date
03/20/2013
Last updated
11/06/2024
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