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1386116952
TRAVIS ROBERT PSOTA
MEDFORD, OR
NPI
1386116952
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-12-20
Last Update Date
2018-12-20
Business Address
TRAVIS ROBERT PSOTA B.S., QMHA
3501 EXCEL DR
MEDFORD, OR 97504-8067
Phone number: 541-630-3125
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Mailing Address
TRAVIS ROBERT PSOTA B.S., QMHA
3501 EXCEL DR
MEDFORD, OR 97504-8067
Phone number: 541-630-3125
Copy
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