Individual
SHELLY MYUME EMI FICKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
724 S CENTRAL AVE, MEDFORD, OR 97501-7851
(541) 249-7724
(541) 325-4055
Mailing address
724 S CENTRAL AVE, MEDFORD, OR 97501-7851
(541) 249-7724
(541) 325-4055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L10457
OR
Other
Enumeration date
01/24/2021
Last updated
01/24/2021
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