Individual
MR. BRODERICK DANIEL BLUES BUCKHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
37875 JASPER LOWELL RD, JASPER, OR 97438-9751
(541) 747-1235
(541) 747-4722
Mailing address
2620 POTTER ST, EUGENE, OR 97405-4124
(503) 383-2481
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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