MICHAEL SIDRIAN

ROSEBURG, OR
NPI1841842853
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  T-19-138)
Enumeration Date2019-07-10
Last Update Date2019-07-10
Business Address
MICHAEL SIDRIAN
548 SE JACKSON ST
ROSEBURG, OR 97470-4983
Phone number: 541-672-2691
Mailing Address
MICHAEL SIDRIAN
PO BOX 1121
ROSEBURG, OR 97470-0254
Phone number:
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