SHANNON NICHOLE MODJESKI

MEDFORD, OR
NPI1265786396
Former NameSHANNON NICHOLE MARCUS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: AZ  LAC14009)
Enumeration Date2012-10-26
Last Update Date2016-06-01
Business Address
-- SHANNON NICHOLE MODJESKI
816 W 10TH ST
MEDFORD, OR 97501-3016
Phone number: 541-734-5437
Mailing Address
-- SHANNON NICHOLE MODJESKI
816 W 10TH ST
MEDFORD, OR 97501-3016
Phone number: 541-734-5437
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