Individual
KIM LUDMILA GRYNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
737 SISKIYOU BLVD, ASHLAND, OR 97520-2141
(541) 517-4715
Mailing address
1257 SISKIYOU BLVD, #194, ASHLAND, OR 97520-2241
(541) 517-4715
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C1749
OR
Other
Enumeration date
02/14/2009
Last updated
02/14/2009
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