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Individual

TRAVIS SANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
228 W 200 S STE 2E, KAMAS, UT 84036-9010
(801) 360-6955
Mailing address
596 ASH CT, KAMAS, UT 84036-9275

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9106771-6004
UT

Other

Enumeration date
06/04/2012
Last updated
03/09/2018
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