Individual
MRS. KELLY ANN KINKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3397 DELTA WATERS RD, MEDFORD, OR 97504-5852
(541) 772-4648
Mailing address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
247000000X
Health Information Technician
—
—
Other
Enumeration date
08/20/2021
Last updated
09/24/2022
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