Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | CI3076 | NV |
Y | 101YP2500X | Professional Counselor | CI3076 | NV |
N | 225400000X | Rehabilitation Practitioner |
NPI | 1013363480 |
---|---|
Provider Name | Lyn Hall |
First Address | Boulder City, NV 89005-1614 |
Second Address | Boulder City, NV 89005-1614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2016 |
Last Update Date | 03/12/2020 |