Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1164725172 |
---|---|
Provider Name | Calvin Rufus JR. |
First Address | Las Vegas, NV 89146-5606 |
Second Address | Las Vegas, NV 89146-5606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2010 |
Last Update Date | 16/12/2019 |