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Bryanna Marie Jellum, SUDP
Addiction (Substance Use Disorder) Counselor in Kelso, Washington
NPI 1760955272

Bryanna Marie Jellum is an Addiction (Substance Use Disorder) Counselor based in Kelso, WA and is specialized in Addiction (Substance Use Disorder). Bryanna Marie Jellum practices in Kelso, WA and has the professional credentials of SUDP. The NPI Number for Bryanna Marie Jellum is 1760955272 and holds a License No. 60279397 (Washington).

The current practice location address for Bryanna Marie Jellum is 404 W Main St, Kelso, WA and can be reached out via phone at 360-423-2806 and via fax at 360-423-5128.

Location: 404 W Main St, Kelso, WA, 98626-1118
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760955272
Provider Name
Bryanna Marie Jellum
Credential
SUDP
Provider Entity Type
Individual
Gender
Female
Address
404 W Main St, Kelso, WA, 98626-1118
Phone Number
360-423-2806
Fax Number
360-423-5128
Provider Enumeration Date
01/07/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
404 W Main St
City
Kelso
State
Washington
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
360-423-5128
person
Provider Business Mailing Address Details
Address
404 W Main St
City
Kelso
State
Washington
Zip
98626-1118
Phone Number
360-423-2806
Fax Number
360-423-5128
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
60279397 (Washington)
Definition
Definition to come...
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