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1194315069
SHELLY MYUME EMI FICKES
MEDFORD, OR
NPI
1194315069
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L10457)
Enumeration Date
2021-01-24
Last Update Date
2021-01-24
Business Address
SHELLY MYUME EMI FICKES LCSW
724 S CENTRAL AVE
MEDFORD, OR 97501-7851
Phone number: 541-249-7724
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Mailing Address
SHELLY MYUME EMI FICKES LCSW
724 S CENTRAL AVE
MEDFORD, OR 97501-7851
Phone number: 541-249-7724
Copy
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