Individual
CRYSTAL ROSE WISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 S MAIN ST, LEBANON, OR 97355-3109
(541) 451-5932
(541) 812-8807
Mailing address
PO BOX 100, ALBANY, OR 97321-0031
(541) 967-3866
(541) 812-8807
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C8013
OR
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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