Organization
TRAVIS RISER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS RISER LCPC (OWNER)
(301) 399-0198
Entity
Organization
Contact information
Practice address
634 WILSON PL, FREDERICK, MD 21702-4168
(301) 399-0198
Mailing address
7820B WORMANS MILL DR, PMB #135, FREDERICK, MD 21701
(301) 399-0198
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912475435
—
MD
Enumeration date
06/05/2019
Last updated
04/20/2022
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