Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1104986850 |
---|---|
Provider Name | Robert Eugene Levert JR. |
First Address | Yreka, CA 96097-9538 |
Second Address | Yreka, CA 96097-9538 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 22/12/2015 |