Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1164848008 |
---|---|
Provider Name | Craig Bird |
First Address | Sparks, NV 89431-6802 |
Second Address | Sparks, NV 89431-6802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2014 |
Last Update Date | 17/03/2014 |