Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003106931 |
---|---|
Provider Name | David Zeiss |
First Address | Eugene, OR 97401-3212 |
Second Address | Eugene, OR 97401-3212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2011 |
Last Update Date | 12/04/2011 |