Individual
TANYA DYDZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BMS
Contact information
Practice address
711 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 474-5579
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 474-5579
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2009
Last updated
05/05/2015
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