Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 00821I | NV |
NPI | 1003252115 |
---|---|
Provider Name | Arturo Gonzalez |
First Address | Pahrump, NV 89048-4765 |
Second Address | Pahrump, NV 89048-4765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2013 |
Last Update Date | 24/06/2013 |