Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1265854517 |
---|---|
Provider Name | Christine St Jean |
First Address | Las Vegas, NV 89170-2843 |
Second Address | Las Vegas, NV 89146-5605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2014 |
Last Update Date | 06/01/2014 |