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1952774101
DONALD SCOTT MICKEY
MEDFORD, OR
NPI
1952774101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2015-11-10
Last Update Date
2019-10-23
Business Address
DONALD SCOTT MICKEY BS
200 BEATTY ST
MEDFORD, OR 97501-5811
Phone number: 541-774-4812
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Mailing Address
DONALD SCOTT MICKEY BS
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373
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