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1497989537
TRAVIS D RODERICK
EUGENE, OR
NPI
1497989537
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-05-04
Last Update Date
2009-05-04
Business Address
-- TRAVIS D RODERICK
1790 W 11TH AVE STE 290
EUGENE, OR 97402-3758
Phone number: 541-686-1262
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Mailing Address
-- TRAVIS D RODERICK
3255 GATEWAY ST APT. 31
SPRINGFIELD, OR 97477-1053
Phone number: 541-510-4051
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