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Individual

CLINTON E KITTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
46314 TIMINE WAY, PENDLETON, OR 97801-9099
(541) 966-9830
(541) 240-8410
Mailing address
46314 TIMINE WAY, PENDLETON, OR 97801-9099
(541) 966-9830
(541) 240-8410

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
L6482
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500681449
OR
Enumeration date
07/29/2014
Last updated
04/15/2020
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