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Individual
TRAVIS ALLEN GRANT
Active
Individual
TRAVIS ALLEN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/06/2013
Last updated
02/19/2019
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