Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 00759-C | NV |
NPI | 1003306663 |
---|---|
Provider Name | Christina Joy Mason |
First Address | Indian Springs, NV 89018-0185 |
Second Address | Indian Springs, NV 89018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2018 |
Last Update Date | 18/05/2018 |