Individual
MR. GAVON MARINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
91150 N COBURG INDUSTRIAL WAY, COBURG, OR 97408-9512
(541) 687-1110
Mailing address
91150 N COBURG INDUSTRIAL WAY, COBURG, OR 97408-9512
(541) 687-1110
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/04/2021
Last updated
11/04/2021
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