Individual
CALLEY DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
1481 KINGS HWY, MEDFORD, OR 97501-4010
(458) 658-9643
Mailing address
1481 KINGS HWY, MEDFORD, OR 97501-4010
(458) 658-9643
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
24-QMHA-R-6005
OR
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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