Individual
KELSEY ANN MADISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1340 NW WALL ST, BEND, OR 97703-1985
(531) 322-7414
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C6043
OR
Other
Enumeration date
03/14/2012
Last updated
03/08/2024
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