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1962231761
TREVOR H ROTH
EVERGREEN, CO
NPI
1962231761
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: CO 09930138)
Enumeration Date
2024-07-30
Last Update Date
2024-07-30
Business Address
TREVOR H ROTH LCSW
1364 HYLAND DR
EVERGREEN, CO 80439-4838
Phone number: 570-460-7368
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Mailing Address
TREVOR H ROTH LCSW
1364 HYLAND DR
EVERGREEN, CO 80439-4838
Phone number: 570-460-7368
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