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1194851808
SHANNON ELAINE PARK
MEDFORD, OR
NPI
1194851808
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OR L3339)
Enumeration Date
2007-02-26
Last Update Date
2012-08-13
Business Address
Ms. SHANNON ELAINE PARK LCSW
145 S, HOLLY STREET SUITE A
MEDFORD, OR 97501-3101
Phone number: 541-773-5664
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Mailing Address
Ms. SHANNON ELAINE PARK LCSW
145 S, HOLLY STREET SUITE A
MEDFORD, OR 97501-3101
Phone number: 541-773-5664
Copy
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