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1003154162
MARK JEFFREY DAVIS
MEDFORD, OR
NPI
1003154162
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2013-01-24
Last Update Date
2021-02-03
Business Address
MARK JEFFREY DAVIS QMHA
1191 HAZEL ST
MEDFORD, OR 97501
Phone number: 541-476-2373
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Mailing Address
MARK JEFFREY DAVIS QMHA
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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