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Mrs. Amy L Bristow, CRM
Peer Specialist in Madras, Oregon
NPI 1659937852

Amy L Bristow is a Peer Specialist based in Madras, OR. Amy L Bristow practices in Madras, OR and has the professional credentials of CRM. The NPI Number for Amy L Bristow is 1659937852 and holds a License No. 19-CRM-100 (Oregon).

The current practice location address for Amy L Bristow is 125 Sw C St, Madras, OR and can be reached out via phone at 541-306-4566 and via fax at 541-320-9005.

Location: 125 Sw C St, Madras, OR, 97741-1458
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1659937852
Provider Name
Amy L Bristow
Credential
CRM
Provider Entity Type
Individual
Gender
Female
Address
125 Sw C St, Madras, OR, 97741-1458
Phone Number
541-306-4566
Fax Number
541-320-9005
Provider Enumeration Date
05/13/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19-CRM-100 01 OR CERTIFIED RECOVERY MENTOR
institution
Provider Business Practice Location Address Details
Address
125 Sw C St
City
Madras
State
Oregon
Zip
97741-1458
Phone Number
541-306-4566
Fax Number
541-320-9005
person
Provider Business Mailing Address Details
Address
125 Sw C St
City
Madras
State
Oregon
Zip
97741-1458
Phone Number
541-306-4566
Fax Number
541-320-9005
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
19-CRM-100 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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