Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1295161438 |
---|---|
Provider Name | Mr. Paul John Sagisi Ong |
First Address | Las Vegas, NV 89130-4806 |
Second Address | Las Vegas, NV 89130-4806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2013 |
Last Update Date | 19/09/2013 |