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1952547903
TRAVIS VAN DEATON
GRANGER, IN
NPI
1952547903
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-12-22
Last Update Date
2015-04-27
Business Address
Mr. TRAVIS VAN DEATON
51960 GUMWOOD RD.
GRANGER, IN 46530-7068
Phone number: 574-247-4665
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Mailing Address
Mr. TRAVIS VAN DEATON
51960 GUMWOOD RD
GRANGER, IN 46530-6207
Phone number: 574-247-4665
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