Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | 7857-S | NV |
Y | 1041C0700X | Clinical Social Worker | IC-1230 | NV |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1144622408 |
---|---|
Provider Name | Justin Lee Arnold |
First Address | Las Vegas, NV 89113-3656 |
Second Address | Las Vegas, NV 89113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2014 |
Last Update Date | 09/11/2020 |