Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 7426 | KS |
NPI | 1003043308 |
---|---|
Provider Name | Stephen Scott Durkin |
First Address | Leavenworth, KS 66048-4435 |
Second Address | Atchison, KS 66002-1297 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2009 |
Last Update Date | 15/06/2009 |