Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor |
NPI | 1033632781 |
---|---|
Provider Name | Jeremy Kjar Elsmore |
First Address | Reno, NV 89502-0912 |
Second Address | Reno, NV 89502-0912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2017 |
Last Update Date | 24/07/2017 |