Individual
DALANA SEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
234 W 5TH ST, MEDFORD, OR 97501-2611
(541) 858-4642
Mailing address
234 W 5TH ST, MEDFORD, OR 97501-2611
(541) 858-4642
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
OR
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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