Organization
QUIET WATERS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLI ANN WICKS LPC (OWNER)
(458) 233-3136
Entity
Organization
Contact information
Practice address
1277 SE SHELTON ST, DALLAS, OR 97338-2537
(458) 233-3136
(800) 433-1396
Mailing address
PO BOX 1787, MEDFORD, OR 97501-0261
(541) 500-8655
(800) 433-1396
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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