Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003152588 |
---|---|
Provider Name | Craig Spotser |
First Address | El Cajon, CA 92020-4015 |
Second Address | El Cajon, CA 92020-4015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2013 |
Last Update Date | 02/01/2013 |