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1770554289
MARK JIM SHELTON
TOOELE, UT
NPI
1770554289
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 128877-3501)
Enumeration Date
2006-02-01
Last Update Date
2007-07-09
Business Address
Mr. MARK JIM SHELTON LCSW
100 S 1000 W
TOOELE, UT 84074-4010
Phone number: 435-843-3520
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Mailing Address
Mr. MARK JIM SHELTON LCSW
355 CHAMPLAINE ST.
TOOELE, UT 84074
Phone number: 435-882-8552
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