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1144622291
JUSTIN SAMUEL MADEIRA
SPRINGFIELD, OR
NPI
1144622291
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2014-09-19
Last Update Date
2014-09-19
Business Address
-- JUSTIN SAMUEL MADEIRA
3995 MARCOLA RD
SPRINGFIELD, OR 97477-7948
Phone number: 541-726-1465
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Mailing Address
-- JUSTIN SAMUEL MADEIRA
3995 MARCOLA RD
SPRINGFIELD, OR 97477-7948
Phone number: 541-726-1465
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