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NPI Code Detail

MEDICARE: KELLIE SITTER PSS

MEDICARE: KELLIE SITTER PSS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1306205836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLIE SITTER PSS
Provider Business Mailing Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6839
Fax Number :
Provider Business Practice Location Address
First Line : 281 LACLAIR ST
Second Line :
City : COOS BAY
State : OR
Zip : 97420-2988
Country : US
Telephone Number : 541-266-6839
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 09/17/2024

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Directions to “ KELLIE SITTER PSS” Practice Location

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