Individual
MARILYN ELLLEN KOVTUNOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
320 E MAIN ST, SUITE 203, ASHLAND, OR 97520-6800
(541) 482-1278
Mailing address
PO BOX 3, ASHLAND, OR 97520-0001
(541) 482-1278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
490
OR
Other
Enumeration date
09/17/2006
Last updated
01/10/2011
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