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1568298461
SHAWN MICHAEL DECALESTA
SPRINGFIELD, OR
NPI
1568298461
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2024-09-09
Last Update Date
2024-09-09
Business Address
SHAWN MICHAEL DECALESTA
3825 INTERNATIONAL CT
SPRINGFIELD, OR 97477-1086
Phone number: 541-858-8170
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Mailing Address
SHAWN MICHAEL DECALESTA
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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