Provider Demographics
NPI:1831493725
Name:PRELLE-TWOREK, CLISTA N (LPC)
Entity Type:Individual
Prefix:MS
First Name:CLISTA
Middle Name:N
Last Name:PRELLE-TWOREK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 C ASHLAND ST
Mailing Address - Street 2:#197
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520
Mailing Address - Country:US
Mailing Address - Phone:541-292-3529
Mailing Address - Fax:541-779-3317
Practice Address - Street 1:523 WAGNER CREEK RD
Practice Address - Street 2:
Practice Address - City:TALENT
Practice Address - State:OR
Practice Address - Zip Code:97540
Practice Address - Country:US
Practice Address - Phone:541-292-3529
Practice Address - Fax:541-482-6462
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor