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Individual
MICHAEL DOUGLAS SODERSTROM
Active
Individual
MICHAEL DOUGLAS SODERSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
17891
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17891
LPC
TX
Enumeration date
05/24/2007
Last updated
07/08/2007
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