Individual
GRANT SCHROEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 672-2691
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C4392
OR
Other
Enumeration date
06/21/2019
Last updated
06/21/2019
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