AUTUMN BASIL ELAM

MEDFORD, OR
NPI1942814801
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2020-09-08
Last Update Date2023-04-04
Business Address
AUTUMN BASIL ELAM
850 SWING LN UNIT 1
MEDFORD, OR 97501-1790
Phone number: 541-622-8592
Mailing Address
AUTUMN BASIL ELAM
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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