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1093283699
JUAN AVILA
THE DALLES, OR
NPI
1093283699
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-11-13
Last Update Date
2018-11-13
Business Address
JUAN AVILA
1021 W 9TH ST
THE DALLES, OR 97058-1007
Phone number: 541-298-1920
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Mailing Address
JUAN AVILA
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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