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1932527504
TRAVIS HENDERSON
MARYSVILLE, CA
NPI
1932527504
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 111101051535)
Enumeration Date
2014-04-01
Last Update Date
2014-04-01
Business Address
-- TRAVIS HENDERSON RAS111101051535
1496 N BEALE RD
MARYSVILLE, CA 95901-6205
Phone number: 530-749-8640
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Mailing Address
-- TRAVIS HENDERSON RAS111101051535
1496 N BEALE RD
MARYSVILLE, CA 95901-6205
Phone number: 530-749-8640
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