Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2015041410 | MO |
NPI | 1003425448 |
---|---|
Provider Name | Herbert Douglas Geiger |
First Address | Liberty, MO 64068-1481 |
Second Address | Liberty, MO 64068-1481 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2020 |
Last Update Date | 30/07/2020 |