Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS19474 | CA |
NPI | 1003234261 |
---|---|
Provider Name | Mr. Ray Ira Apter |
First Address | Long Beach, CA 90808 |
Second Address | Long Beach, CA 90808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2014 |
Last Update Date | 03/04/2014 |