Individual
MS. JUDY D ZELLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 HIGH ST, EUGENE, OR 97401-3240
(541) 762-4300
Mailing address
687 CHESHIRE AVE, EUGENE, OR 97402-5060
(541) 343-2993
(541) 343-2338
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-21-806
OR
175T00000X
Peer Specialist
4395998
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4395998
—
OR
Enumeration date
06/05/2017
Last updated
09/18/2024
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