Individual
KELLY BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
750 BIDDLE RD, MEDFORD, OR 97504-6178
(541) 690-1995
(541) 749-2126
Mailing address
750 BIDDLE RD, MEDFORD, OR 97504-6178
(541) 690-1995
(541) 749-2126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24-CRM-3330
OR
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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