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Individual
ROGER W OGREN
Active
Individual
ROGER W OGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LAC-LAC-LIC-1237
MT
Other
Enumeration date
11/05/2014
Last updated
11/05/2014
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