Individual
KELLY LYNN JEFFRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAS,CADC II
Contact information
Practice address
221 W MAIN ST, MEDFORD, OR 97501-2728
(541) 200-2401
Mailing address
221 W MAIN ST, MEDFORD, OR 97501-2728
(541) 200-2401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-05-16
OR
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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